IPACHTE#�l5=` '� 5 Harnett County Department of Public Health28469
Imarovement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: /GX1 Ce2 CiZ 4) .-moi
ISSUED TO O�iK 'e—e"p�s SUBDIVISION LOT #
NEW Y REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure:
Proposed Wastewater System Type:
Projected Daily Flow: GPD
Number of bedrooms: Number of Occupants: max
Basement ❑Yes No
Pump Required: Yes ❑ No ❑ MMa�* required based on final location and elevations of facilities
Type of Water Supply: ❑ Community I[f Public ❑ Well Distance from well feet Permit valid for. 2"Five years
Permit conditions: ❑ No expiration
Authorized State v Date: 1 ! Y % �' SEE ATTACHED SITE SKETCH
The issuance of this permit b e Heal Department in no way guarantees the issuance of o er permits. The permit holder is responsible for checking with appropriate governing bodies in meeting their requirements. This
site is subject to revocation a 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 T0: , r��D PROPERTY LOCATION: /T-24 ®1)-)
SUBDIVISIONr /.t�T�25 LOT # /
Facility Type: New ❑ Expansion ❑ Repair
Basement? ❑ Yes 2""'N o Basement Fixtures? ❑ Yes
Type of Wastewater System** (Initial) Wastewater Flow: a GPI
(See note below, if applicable ❑)
(Repair)
Installation Requirements/Conditions Number of trenches 3 �7�`
Septic Tank Size gallons Exact length of each trench feet Trench Spacing: Feet on Center
Pump Tank Size e' D gallons Trenches shall be installed on contour at a Soil Cover: inches
Maximum Trench Depth of: 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
Aggregate Depth:
Conditions:
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.
_ a inches below pipe
inches above pipe
inches total
**If applicable: /understand the system type specified is different from the type speciled on the application. / accept the specifications of thio 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 Disposa nd to the conditions of this permit Itt Al IALHtV IIlt MILH
Authorized State Date: ''7''/ '7 5 `�
Construction Authorization Expiration Date:,-
HTE# 8'—t5--_3'0 y�
Permit # Zc? �16
Harnett County • i, Lt • of PublicHealth
Site Sketch
PROPERTY MATO 60 6. oiln 5 .�-
ISSUED TO: SUBDIVISION LOT #
Authorized State Agent,•'` // i �' Date: -7 X 67--15 "�
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: 5_r��
Address: Date Evaluated: Z`""�-1 Lr
Proposed Facility: Design Flow(. 1949): �(o�
Location of Site: Property Recorded:
Water Supply: �'ublic❑ Individual ❑ Well
Evaluation Method:Auger Morin ❑ Pit ❑ Cut
Type of Wastewater: ewage ❑ Industrial Process
Sheet:
Property ID:
Lot #:
File #:
Code:
Property Size:
❑ Spring ❑ Other
❑ Mixed
P
R
O
F
I .1940
L Landscape Horizon
E Position/ Depth
# Slope % (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
D
150-10
ja-
let
Description Initial Repair System Other Factors (.1946):
System Site Classification (.1948):7
Available Space(. 1945) Evaluated By:
System T e(s) S Others Present:
Site LTAR t{