IPAC RHTE3f C /2 Harnett County Department of Public Health 28262
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
_ PROPERTY LOCATION:ta-
ISSUED TO: J *� el' �� k 1 SUBDIVISION _ LOT #
NEW 2-' REPAIR ❑ EXPANSION ❑
Type of Structure: m 4 %c.1 ?Y
Proposed Wastewater System Type: 6V �Ce�vc :,ti �yl7 r
Projected Daily Flow: q e GPD
Number of bedrooms: Number of Occupants: max
Basement ❑Yes No
Site Improvements required prior to Construction Authorization Issuance:
Pump Required: ❑Yes ❑ No L<ay be required based on final location and elevations of facilities
Type of Water Supply: El Community El Public iff Well Distance from well /00 feet
Permit conditions:
Permit valid for:
eve years
❑ No expiration
Authorized State Agent:-. �cr� /��%�—�A f/ Date: W/ 12-01r " SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health t in no way guarantees the issuance of other permits. The permit holder 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: PROPERTY LOCATION: s"): E C' '_'r le C1
L �/" SUBDIVISION LOT #
Facility Type: CT 5 New ❑ Expansion ❑ Repair
Basement? ❑ Yes ❑ No Basement Fixtures? ❑ Yes ❑ No
Type of Wastewater System** (Initial) Wastewater Flow: 5Y80 GPD
(See note below, if applicable ❑) pp
v,,, f41.- (Repair)
Installation Requirements/Conditions Number of trenches
Septic Tank Size ICO0 gallons Exact length of each trench 4/00 feet Trench Spacing: Feet on Center
Pump Tank Size 100 0 gallons Trenches shall be installed on contour at a Soil Cover: (I inches
Maximum Trench Depth of: /8 inches (Maximum soil cover shall not exceed
(Trench bottoms shall be level to +/-1/4" 36" above the trench bottom)
in all directions)
Pump Requirements: ft. TDH vs. GPM
Conditions: �_- h'. fU
Aggregate Depth:
WATER LINES (INCLUDING IRRIGATION) MUST BE ]OFT. FROM ANY PART OF SEPTIC SYSTEM OR REPAIR AREA.
NO UTILITIES ALLOWED IN INITIAL OR REPAIR DRAIN FIELD AREA.
inches below pipe
inches above pipe
inches total
**If applicable: /understand the system type speriled is different from the type speciled on the application. /accept the rpecifcationr of this permit.
Owner/Legal Representative Signature: Date:
This Construction Authorization is subiect to revocation if the site Alan. Oat, or the intended use changes. The Construction Authorization shall not he transferred when there is a rhnnae in nwnerthin of rhe site Thi
Construction Authorization is subject to compliance with the provisions of the Laws and Rules for
Authorized State
Treatment and Disposal and to the conditions of this permit VSEE ATTACHED SITE SKETCH
Date: ,3 /-"! l,2 al -r—
Construction Authorization Expiration Date: 3 /2//.LOR0
HTE #�L G % A _ Permit # o? 6 Z �- 2,
Harnett County Department of Public Health
Site Sketch
PROPERTY LOCATON:
ISSUED T0: Me a ( SUBDIVISION LOT #
Authorized State Agent: e111, Date:
/2o/T
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: Sac t�
Proposed Facility: Design Flow (.1949):
Location of Site: Property Recorded:
Water Supply: ❑ Public❑ Individual ell
Evaluation Method:a Auger Bori El pit ❑ Cut
Type of Wastewater: Sewage ❑ Industrial Process
Sheet:
Property ID:
Lot #:
File #:
Code:
Property Size:
❑ Spring
❑ Mixed
❑ Other
P
R
O
F
I
L
E
#
.1940
Landscape
Positions
Slope
Horizon
Depth
(In.)
SOIL MORPHOLOGY
.1941
OTHER
PROFILE FACTORS
Profile
Class
& LTAR
.1941
Structure/
Texture/
.1941
Consistence
Mineralo-gym/
.1942
Soil
Wetness/
Color
1943.1956
Soil
Depth (IN.)
Sapro
Class
.1944
Restr
Horiz
J6 � 0
6 -oZ�
C- �/
X,
Description Initial Repair System Other Factors (.1946):
System Site Classification (.1948): If
Available Space (.1945) Evaluated By:�.*--
System Type(s) C 2 ! _ Others Present: j
Site LTAR , c c