IPAC'ITE#_1 S- 5-3(-GOL� Harnett County Department of Public Health 2 8 3 5 1
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
�^ PROPERTY LOCATION: W `v c6 o fly
ISSUED T0: SUBDIVISION 1A a YkP. t a c, LOT # 1 G
N EW>< REPAIR ❑ EX ON ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: SF
Proposed Wastewater System Type: `>—� °7/o 9 y Cs t.
Projected Daily Flow: S Cm GPD
Number of bedrooms: 3 Number of Occupants: max
Basement ❑Yes No
Pump Required: ❑Yes K No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community Public ❑ Well Distance from well 100 feet Permit valid for: ive years
Permit conditions: -- I ❑ No expiration
Authorized State Agent:: ��� }j5 Date: '? 1 n 0 l SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the issuance o ther permits. The permit holdk 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 PROPERTY LOCATION: ``J Q, E ®*r 4�7t
o
SUBDIVISION `�1 i 0 c�a,� � �+v (i LOT # ,' So
facility Type: S>`s6� "S`tr� New ❑ Expansion ❑ Repair
Basement? ❑ Yes No
Basement Fixtur s7 ❑ es No
`�
Type of Wastewater System**
C --D I c.., \ Q A/
(See note below, if applicable ❑)
�.S �!
o�-6,�_J
Cry s Q
(Repair)
Installation Requirements/Conditions
Number of trenches
Septic Tank Size M(0 O
gallons
Exact length of each trench
90
Pump Tank Size
gallons
Trenches shall be installed on contour at a
Maximum Trench Depth of:
,'%
Pump Requirements: ft. TDH vs.
Conditions:
(Trench bottoms shall be level to +/-1/4"
in all directions)
GPM
(Initial) Wastewater Flow: ' kYO GPD
feet Trench Spacing: Feet on Center
Soil Cover: �—_ — 1`i inches
inches (Maximum soil cover shall not exceed
36" above the trench bottom)
Aggregate Depth:
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.
inches below pipe
inches above pipe
inches total
**If applicable: / understand the system type speciled is different from the type speciled on the application. / accept the specifications of this permit.
Owner/Legal Repre Si nature: Date:
This Construction Authorization is subject to revoca' ' 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 t to compliance�the prove ' of the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit. SEE ATTACHED SITE SKETCH
Authorized State Agent:
qx_' As Date: `I ) n
Construc-'ion Authorization Expiration Date: y /
HTE# Permit # Q�—� �5 0
Harnett County Department of Public Health
Site Sketch
PROPERTY LOCATON:
ISSUED TO: � SUBDIVISION —7%i bf\3N5 AC>, NO'(Z— LOT #
Authorized State Agent: -'0 LI -4a �-TOI--,15WT) Date: �' ��
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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:
Proposed Facility: pr.�` Design Flow (.1949):
Location of Site: Property Recorded:
Water Supply: Public❑ Individual ❑ Well
Evaluation Method: Auger B 'ring ❑ Pit ❑ Cut
Type of Wastewater: Sewage ❑ Industrial Process
Sheet:
Property ID:
Lot #:
File #:
Code:
Property Size:
❑ Spring
❑ Mixed
❑ Other
P
R
O
F
1 .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
!`lp�tz e-0 G
�-
d
G 5
\J- P1
Description Initial R pair System Other Factors (.1946):
S st Site Classification (1948)'4.5
Available Space(. 1945) Evaluated By:
System Type(s)--- a, Others Present:
Site LTAR> 4