IPACHTE# r-5�Harnett County Department of Public Health 28349
Improvement Permit
A building permit cannot be issued with only an Improvement Permit {�
PROPERTY LOCATION: N c�GC.-��P��'ils
ISSUED TO: a�f(at..:t� ` �a=(�.N"� E p`'1\�� r 1S SUBDIVISION LOT #
NEW'' REPAIR ❑ EXP ION 1:1Type of Structure: ��� �, �� x 5 a
Proposed Wastewater System Type: 20SO 9--E-Dvc%� I Z)N'S"7-s "fPm
Projected Daily Flow: `3 QQ GPD
Number of bedrooms: 3 Number of Occupants: max
Basement ❑Yes I
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: ❑ Community X Public ❑ Well Distance from well ® feet
Permit conditions:
Permit valid for:
No
ive years
expiration
Authorized State Agent: �� ~ ` \-45 Date: '71119 \ SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees t e ce of other permits. The permit holdelf is res onsible 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 Imprbement 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.
1
ISSUED T0: Qc�c�t=S7 `��� �£ t��\ ' PROPERTY LOCATION: ',0C.C_ C'� (b N91 VbC-
SUBDIVISION LOT #
Facility Type: �� ��� New ❑ Expansion ❑ Repair
Basement? ❑ Yes --9. No Basement Fixtures.? LJ Yes 'KNo
0
Type of Wastewater System** (QLS '3 s"� 6sr\ (Initial) Wastewater Flow: 3f_0 GPD
(See note below, if applicable ❑) j
� u .e y (Repair)
Installation Requirements/Conditions Number of trenches _ H
Septic Tank Size t o ® g gallons Exact length of each trench feet
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of. A � inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
Pump Requirements: ft. TDH vs. GPM
Conditions:
Trench Spacin : Feet on Center
Soil Cover: "ate 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: /understand the system type specired is different from the type specired on the application. / accept the specifications of this permit.
Owner/legal Representative Signature: Date:
This Construction Authorization i; wbiect to revocation if the site Dian, plat or the intended use changes. The Construction Authorization shall not be transferred when there is a change in ownershio of the site. This
Construction Authorization is sq,6ject to cortfffl R ' theft s.os of the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit. SEE ATTACHED SITE SKETCH
Authorized State Agent: RAS Date: $
uction Authorization Expiration Date:
HTE # 5— Permit # 9
Harnett County ]Department of Public Health
Site Sketch
PROPERTY LOCATON: ?Q� t5\ GQVNC VZ�
ISSUED TO: 00 ZN GT,�-�NE Q W\N�SUBDIVISION LOT
Authorized State Agent:�,*5(VL-\\jtA--7 Date: 15—
S4,
I
0
-* Qvc-,-1NON', Pq-,C)P�
–T OJ
M
Department of Environment, Health and Natural Resources Sheet:
Division of Environmental Health Property ID:
On -Site Wastewater Section Lot #:
File #:
SOIL/SITE EVALUATION Code:
for ON-SITE WASTEWATER SYSTEM
Owner: Applicant:
Address: Date Evaluated:
Proposed Facility: Design Flow (1949): Property Size:
Location of Site: Property Recorded:
Water Supply: ❑ Public❑ Individual ❑ Well ❑ Spring ❑ Other
Evaluation Method: ❑ -Auger Boring ❑ Pit ❑ Cut
Type of Wastewater: ❑ Sewage ❑ Industrial Process ❑ 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
l
a
Ly
o.r
Co-,.
s-ZCo
5c -C �
A.
ZZ-Zy • a,o
C v
i®-3-7
(-,
1
44
Eb _ j�D
1g -2Y s
T2."S0/
`3
Description Initial Repair System Other Factors (.1946):
S ste Site Classification (1948):
Available Space (.1945) Evaluated By<)"�
System Type(s) to P Uri Others Present:
Site LTAR 3 •'i,