IPACHTE#,�� — 5— ��� 3 Harnett County Department of Public Health 28453
Improvement Permit
Authorized State k6fint, Z` ' J( Date: 4 L s ® SEE ATTACHED SITE SKETCH
The issuance of this permit b health 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.
ISSUED TO: /G ��C , PROPERTY LOCATION:
/ SUBDIVISION LOT #
Facility Type:New ❑ Expansion ❑ Repair
Basement? ❑ Yes No Basement Fixtures? ❑ Yes Ci' No
Type of Wastewater System** Z S1/o ;CFbl)U-TOD _ (Initial) Wastewater Flow: S60 GPD
(See note below, if applicable ❑) '
5 7�r, (Repair)
A building permit cannot be issued with only an Improvement Permit
Number of trenches
Septic Tank Size gallons
Exact length of each trench D feet
PROPERTY LOCATION:y/7S
Trenches shall be installed on contour at a
ISSUED T0:
Maximum Trench Depth of: --,76-W bL inches
SUBDIVISION
LOT #
NEW
REPAIR ❑
EXPANSION Site Improvements required prior to Construction Authorization Issuance:
Type of Structure:
Jf.t
ill 14
Proposed Wastewater
System Type: ;Z
iZ-04,, tl c rZ.d1___-
Projected Daily Flow:
3 6--b
GPD
Number of bedrooms:
3
Number of Occupants: max
Basement ❑Yes
C�No
Pump Required: ❑Yes ❑ No
Type of Water Supply: El Community
2`May be required based on final location and elevations of facilities
2 Public ❑ Well Distance from well feet
Permit valid for. 2 Five years
Permit conditions:
❑ No expiration
Authorized State k6fint, Z` ' J( Date: 4 L s ® SEE ATTACHED SITE SKETCH
The issuance of this permit b health 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.
ISSUED TO: /G ��C , PROPERTY LOCATION:
/ SUBDIVISION LOT #
Facility Type:New ❑ Expansion ❑ Repair
Basement? ❑ Yes No Basement Fixtures? ❑ Yes Ci' No
Type of Wastewater System** Z S1/o ;CFbl)U-TOD _ (Initial) Wastewater Flow: S60 GPD
(See note below, if applicable ❑) '
Conditions:
Trench Spacing: / Feet on Center
Soil Cover g!� inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
inches below pipe
Aggregate Depth: Z inches above pipe
%_- inches total
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.
**If applicable: /understand the system type specified is different from the type specifled on the application. / accept the specifications 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 Agent:r'/, -%,r Date:
Construction Authorization Expiration Date: 2 y
5 7�r, (Repair)
Installation Requirements/Conditions
Number of trenches
Septic Tank Size gallons
Exact length of each trench D feet
Pump Tank Size gallons
Trenches shall be installed on contour at a
Maximum Trench Depth of: --,76-W bL inches
(Trench bottoms shall be level to +/-IR'
in all directions)
Pump Requirements: ft. TDH vs.
GPM
Conditions:
Trench Spacing: / Feet on Center
Soil Cover g!� inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
inches below pipe
Aggregate Depth: Z inches above pipe
%_- inches total
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.
**If applicable: /understand the system type specified is different from the type specifled on the application. / accept the specifications 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 Agent:r'/, -%,r Date:
Construction Authorization Expiration Date: 2 y
H T E # /3 :5--- 7(. 5,' 3 Permit # Z `� 5-. �
Harnett County Department of Public Health
Site Sketch
ISSUED TO:
PROPERTY LOCATON: ` Ud 4ww-- C. e, ,o "
SUBDIVISION LOT #
Authorized State A¢ent':'`�� �� .���f Date:
-7x-Ig66
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:ate Evaluated: 6--4 4LS__..
Proposed Facility: �-J Design Flow (.1949):
Location of Site: Property Recorded:
Water Supply: ublic❑ Individual ❑ Well
Evaluation Method:E3"Auger Boring ❑ Pit ❑ Cut
Type of Wastewater: ❑,,,Sewage ❑ Industrial Process
Sheet:
Property ID:
Lot #:
File #:
Code:
Property Size:
❑ Spring ❑ Other
❑ Mixed
Description Initial Repair System Other Factors (.1946):
System / Site Classification (.1948):
Available Space(. 1945) Evaluated By:
System Type(s) T141Others Present:
Site LTAR `l
P
R
O
F
I
L
E
#
.1940
Landscape
Position/
Slope %
Horizon
Depth
(In.)
SOIL MORPHOLOGY
.1941
OTHER
PROFILE FACTORS
1941
Structure/
Texture
.1941
Consistence
Mineralogy
.1942
Soil
Wetness/
Color
.1943
Soil
Depth (IN.)
.1956
Sapro
Class
.1944
Restr
Horiz
Profile
Class
& LTAR
1, L
LJ4%
®
K
r✓
v -94
5L
,�A'_ Ce- A sw
Description Initial Repair System Other Factors (.1946):
System / Site Classification (.1948):
Available Space(. 1945) Evaluated By:
System Type(s) T141Others Present:
Site LTAR `l