IPACHTE# 1 5-5 3S-3 1 Harnett County Department of Public Health 28508
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: iZo2�-\t) cTON
ISSUED T0: ��cri ES A(t.�CJ �-�L\eel SUBDIVISION LOT #
NEW REPAIR ❑ EXPANSION ❑
Type of Structure: M N.4 . Vk O M a
Proposed Wastewater System Type
Projected Daily Flow: 3 c:>0� GPD
Number of bedrooms: 3 Number of Occupants: max
Basement ❑Yes )KNo
Site Improvements required prior to Construction Authorization Issuance:
Pump Required: ❑Yes ;KNo ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community X Public ❑ Well Distance from well 1 0--) feet
Permit conditions: — --�
Permit valid for:
Five years
❑ No expiration
Authorized State Agent:: � Nye � CJS Date: '%I C ! ) SSEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the iss W 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 Improve ts�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, .1957, .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:Acn�S �t>,2� Cu¢Q1N PROPERTY LOCATION: V -.D
SUBDIVISION LOT #
Facility Type: Mia , SME. QC""1) X New ❑ Expansion ❑ Repair
Basement? ❑ Yes )Z� No Basement Fixtures? ❑ Yes X No 3��
Type of Wastewater System** a ®lo v � s a W am
l, Ern (Initial) Wastewater Flow: GPD
(See note below, if applicable ❑)
"!0 V-4'e.pv(:57) au (Repair)
Installation Requirements/Conditions Number of trenches 3
Septic Tank Size 14D C,0 gallons Exact length of each trench t 04 feet
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of: t'?) inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
Pump Requirements: ft. TDH vs. GPM
Conditions:
Trench Spacing: Feet on Center
Soil Cover: inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
Aggregate Depth:
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.
inches below pipe
inches above pipe
inches total
**If applicable: l understand the system type specified is different from the type specified on the application. / accept the specifIcatioas of this permit.
Owner/Legal Representa"ture: Date:
This Construction Authorization is subject to ion if t to 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 compliance ran of the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent:
Date: B
Authorization Expiration Date:
HTE# IS -5-16-111 1 Permit # M507
Harnett County Department of Public Health
Site Sketch
PROPERTY LOCATON: 0acUL) t4 i 0 M 910
ISSUED TO: °` PatZ`�. C-vw. -A tj SUBDIVISION LOT #
Authorized State Agent: (sLI J6YZ T,0 LA<54 oam-
.i
Date: � 41; TS
G'0I7
E; 7S .
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: prL MS Design Flow (.1949):3
Location of Site: Property Recorded:
Water Supply: [5fublic❑ Individual ❑ Well
Evaluation Method: Auger Boring ❑ Pit ❑ Cut
Type of Wastewater EYewage ❑ 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
Mineraloiigy
.1942
Soil
Wetness/
Color
.1943
Soil
Depth (IN.)
.1956
Sapro
Class
.1944
Restr
Horiz
,�>�
;
�1� �t'4
ri
3)<
G
X 4)09
A�
Description Initial Re air System Other Factors (.1946):
S ste Site Classification (.1948):
Available Space (.1945) Evaluated By:
System T e(s) /c �L R Others Present:
Site LTAR 3
s,
3x 3v" 1Z,�6 �`U