IPACHTE#�" — `� Harnett County Department of Public Health
28398
Imarovement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION -St— 9 /O 14X* t%
ISSUED T0:r� SUBDIVISION LOT #
NEW F,� REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure:
Proposed Wastewater System Type:
Projected Daily Flow: 3 L& 0 GPD
Number of bedrooms: 3 Number of Occupants: max
Basement ❑Yes l -lo �
Pump Required: ❑Yes 11 No E3'Ma a required based on final location and elevations of facilities
Type of Water Supply: ❑ Community 12r Public ❑ Well Distance from well feet Permit valid for: C7'ive years
Permit conditions: ❑ No expiration
Authorized State Agefit::__.i�/' lR-),„ Date: C,- — /(— —/ S SEE ATTACHED SITE SKETCH
The issuance of this permit by VHealth Department in no way guarantees the issuance of 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. rr
ISSUED TO: Czlii,�� s —s PROPERTY LOCATION: 'SXf a/l b 04K 1/(V,4 t,P„ 4
;�, SUBDIVISION LOT #
Facility Type: Com' '— f 0 New E;,, Expansion ❑ Repair
Basement? ❑ Yes No Basement Fixtures? ❑ Yes �No
Type of Wastewater System** %5a /o '>U�_ r�— �, (Initial) Wastewater Flow: 3 (-6 GPD
(See note below, if applicable ❑)
®%, Repair)
Installation Requirements/Conditions Number of trenches
Septic Tank Size 04- 0 gallons Exact length of each trench 100, feet Trench Spacing: Feet on Center
Pump Tank Size gallons Trenches shall be installed on contour at a Soil Cover: inches
Maximum Trench Depth of. ZR, J$ 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 inches below pipe
Conditions:
Aggregate Depth: inches above pipe
%L inches total
WATER LINES (INCLUDING IRRIGATION) MUST BE 10FT. FROM ANY PART OF SEPTIC SYSTEM OR REPAIR AREA.
NO UTILITIES ALLOWED IN INITIAL OR REPAIR DRAIN FIELD AREA.
**If applicable: / understand the system type specified is different from the type speciped on the application. / accept the specipcations of this permit.
Owner/Legal Representative Signature: Date:
This Construction Authorization is subject to revocation if the site plan, plat, or the intended use changes. The Construction Authorization shall not be transferred when there is a change in ownership of the site. This
Construction Authorization is subject to compliance with the provisions of the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit. SEE ATTACHED SITE SKETCH
Authorized State
- i
Construction Authorization Expiration Date: (g -_
HTE# /SS'- S -
Permit # ,Z S -S '3,,E
Harnett County Department of 1Health
Site Sketch
_n 2 , PROPERTY LOCATON:25 _/I/U K �� G -> P-6
ISSUED TO: �GY /�7�'� SUBDIVISION LOT #
Authorized State nt: G Date: — 1!5—
IS/2-
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.sf2- OAK Vs -/le y F�
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: !1'_ �
Address: Date Evaluated: lo- /2166
Proposed Facility: Design Flow (A 949)y�-a
Location of Site:Property Recorded:
Water Supply: Public❑ Individual ❑ Well
Evaluation Method: Auger Boring ❑ Pit r-1cut
Type of Wastewater: ❑Sewage ❑ Industrial Process
Sheet:
Property ID:
Lot #:
File #:
Code:
Property Size:
❑ Spring ❑ Other
❑ Mixed
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
JL
3 cf
,�-
�, �•st�r
Description Initial Repair System Other Factors (.1946):
System Site Classification (.1948):
Available Space (1945) V Evaluated By
�
System Type(s) S e3Y.--> TIM Others Present:
Site LTAR -S