IPACHTE# �1-5--YD-30) Harnett County Department of Public Health
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY IO(ATION• i -.N
ISSUED TO: G® v'c4-� 1-4U SUBDI'
NEWX REPAIR EX ANSION 11Type of Structure: S " x
Proposed Wastewater System Type: 9-�3o o i--DvLltors -,N
Projected Daily Flow: GPD
Number of bedrooms: Number of Occupants: max
Basement ❑Yes � 'No
LOT #
Site Improvements required prior to Construction Authorization Issuance:
Pump Required: ❑Yes ><No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: F-1Community�� Public ElWell Distance from well d fj® feet Permit valid for: Five years
Permit conditinnc _ ❑ No expiration
Authorized State Agent:: �`�� Date: SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the issu hof other permits. The permit holder is responsible for checking with appropriate governing bodies in meeting their requirements. This
site is subject to revocation if the site plan, plat, or the intended use changes. The Improvement Permit shall not be affected by a change in ownership of the site. This permit is subject to compliance with the provisions of
the Laws and Rules for Sewage Treatment and Disposal and to conditions of this permit..
Construction Authorization
(Required for Building Permit)
The construction and installation requirements of Rules .1950, .1952, .1954, .1955, .1956, .1951, .1958. and .1959 are incorporated by references into this permit and shall be met Systems shall be installed in accordance
with the attached system layout.
ISSUED TO: SO ult) `�c.�v ��i�- PROPERTY LOCATION:
SUBDIVISION 10—U N�5 t_J F1Z LOT # fS®
Facility Type: S;: -D �- 3g New ❑ Expansion ❑ Repair
Basement? ❑ Yes >Rr No Basement Fixtures? ❑ Yes No
Type of Wastewater System** 0'.S10 - wc, t G N S y (Initial) Wastewater Flow: 3 ® GPD
(See note below, if applicable ❑) <DJ�V
n S -75 (Repair)
Installation Requirements/Conditions Number of trenches QL
Septic Tank Size ! <D O 0 gallons Exact length of each trench 90 feet
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of- V& inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
Pump Requirements: ft. TDH vs. GPM
Conditions:
Trench Spacing: i Feet on Center
Soil Cover: G inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
inches below pipe
Aggregate Depth: inches above pipe
inches total
WATER LINES (INCLUDING IRRIGATION) MUST BE LOFT. FROM ANY PART OF SEPTIC SYSTEM OR REPAIR AREA.
NO UTILITIES ALLOWED IN INITIAL OR REPAIR DRAIN FIELD AREA.
**If applicable: l understand the system type specifed is different from the type specified on the application. l accept the specifications of this permit.
Owner/Legal Representative Signature: Date:
This fnnstrurrinn Authorization is suhiect-Ta—revoration if the site plan. olat or the intended use changes. The Construction Authorization shall not be transferred when there is a chancre in ownershiD of the site. This
Construction Authorization is sr to complia ith the�ip Driuthe Laws and Rules for Sewage Treatment and Disposal and to the conditions of this
Authorized State Agent: Date:
ons on Authorization Expiration Date:
A
SEE ATTACHED SITE SKETCH
HTE# S 30 Permit # � YC(
Harnett County ' 1 of 1Health
Site Sketch
PROPERTY LO(ATON: Fes, :z\E
ISSUED TO: 1 �� eo SUBDIVISION ik.c s—,G25y IE o-,, U14 LOT # S
Authorized State Agent: 5-�5 ibL�v ox�sDaS2� Date:
M
T cL g l a) C L-0
Department of Environment, Health and Natural Resources
Division of Environmental Health
On -Site Wastewater Section
SOIL/SITE EVALUATION
for ON-SITE WASTEWATER SYSTEM
Owner: Applicant:
Address: Date Evaluated: 3 ��
Proposed Facility: Design Flow (.1949):�C.
Location of Site:Property Recorded:
Water Supply: ublic❑ Individual ❑ Well
Evaluation Method: Er Bing ❑ Pit ❑ Cut
Type of Wastewater: ❑–Seyvage ❑ Industrial Process
Sheet:
Property ID:
Lot #:
File #:
Code:
Property Size:
❑ Spring
❑ Mixed
❑ Other
P
R
O
F
I
L
E
#
.1940
Landscape
Position/
Slope %
Horizon
Depth
(In.)
SOIL MORPHOLOGY
.1941
OTHER
PROFILE FACTORS
Profile
Class
& LTAR
.1941
Structure/
Texture
.1941
Consistence
Mineralogy
.1942
Soil
Wetness/
Color
.1943
Soil
Depth (IN.)
.1956
Sapro
Class
.1944
Restr
Horiz
Fn » Imo(
a 55
4 y
)_J�w_
-S3x5CL
Description Initial Re air System Other Factors (.1946):
S stem% Site Classification (.1948): —
Available Space (.1945) v Evaluated By: C 1
System Type(s) Others Present:`1
Site LTAR