IPACHTE# /s=,s-,71-79 Harnett County Department of Public Health 28426
Imarovement Permit
Authorized State Agent:: "I- Date: d/ 2o/1— SEE ATTACHED SITE SKETCH
The issuance of this permit by tWrlealth 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
A building permit cannot be issued with only an Improvement Permit
(Required for Building Permit)
9cv
l PROPERTY LOCATION: /,cc- Cnu.ti'�r L ", -"(jISSUED
Be_44ec'
with the attached system layout.
TO-
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SUBDIVISION
LOT # _
NEW
REPAIR ❑ ,
EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure:
y lel
IA8
Repair
Proposed Wastewater System Type: d,i'r
Basement Fixtures? ❑ Yes ❑ No
Projected Daily Flow:
�6 0
GPD
(See note below, if applicable ❑)
Number of bedrooms:
Number of Occupants: C max
�5"% ,,�e�v�.-�c�� �i✓/"�� (Repair)
Basement ❑Yes
2110
Septic Tank Size /000
Pump Required: ❑Yes
E4 -No
❑MMayy e required based on final location and elevations of facilities
gallons Trenches shall be installed on contour at a
Type of Water Supply:
El Community
L Public ❑ Well Distance from well feet Permit valid for:
EtFve years
Permit conditions:
(Trench bottoms shall be level to +/-1/4"
36" above the trench bottom)
❑ No expiration
Authorized State Agent:: "I- Date: d/ 2o/1— SEE ATTACHED SITE SKETCH
The issuance of this permit by tWrlealth 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..
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.
inches below pipe
inches above pipe
inches total
**If applicable: / understand the system type specified is different from the type specified on the application. /accept the specifications of this permit.
Owner/Legal Representative Signature: Date:
This Construction Authorization is subiect to revocation if the site plan. plat or the intended use chanties. The Construction Authorization shall not be transferred when there is a chanve in nwnershin of rhe %ite_ Thi%
Construction Authorization is subject to compliance with the
Authorized State Agent:
of the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
A
Date:
Construction Authorization Expiration
/'o tell"
ro z�zo
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:y Ic;-
PROPERTY LOCATION:
kee ccs -k4y led
Facility Type: /419
SUBDIVISION
2
LOT # �/
New ❑ Expansion ❑
Repair
Basement? ❑ Yes C"No
Basement Fixtures? ❑ Yes ❑ No
Type of Wastewater System**
(Initial) Wastewater Flow: 3 GPD
(See note below, if applicable ❑)
�5"% ,,�e�v�.-�c�� �i✓/"�� (Repair)
Installation Requirements/Conditions Number of trenches .3
Septic Tank Size /000
gallons Exact length of each trench 8 13
feet Trench Spacing: `� Feet on Center
Pump Tank Size
gallons Trenches shall be installed on contour at a
Soil Cover: inches
Maximum Trench Depth of. /8 -Z®
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.
inches below pipe
inches above pipe
inches total
**If applicable: / understand the system type specified is different from the type specified on the application. /accept the specifications of this permit.
Owner/Legal Representative Signature: Date:
This Construction Authorization is subiect to revocation if the site plan. plat or the intended use chanties. The Construction Authorization shall not be transferred when there is a chanve in nwnershin of rhe %ite_ Thi%
Construction Authorization is subject to compliance with the
Authorized State Agent:
of the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
A
Date:
Construction Authorization Expiration
/'o tell"
ro z�zo
HTE# lS` s'' 3 67/2 Permit # '? �s (Z t,
Harnett County Department of Public Health
Site Sketch
/� ` PROPERTY LOCATON: 4-a e- C o w -4- � e leci
ISSUED TO: r Je 0 [ -k �e�e t. SUBDIVISION LOT #
c
Authorized State Agents , ,-,-- ,�'`� Date: /CJ/C-
I to
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: 17
Address: Date Evaluated:
Proposed Facility: Design Flow (.1949):
Location of Site: Property Recorded:
Water Supply:Public❑ Individual ❑ Well
Evaluation Method: ❑4u -ger Boni g ❑ Pit ❑ Cut
Type of Wastewater: wage ❑ Industrial Process
Sheet:
Property ID:
Lot #:
File #:
Code:
Property Size:
❑ Spring
❑ Mixed
❑ Other
P
R
O
F
1
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
fv�
v
Description Initial Repair System Other Factors (.1946):
System Site Classification (.1948):
Available Space(. 1945) Evaluated By:
System Type(s) Others Present:
Site LTAR . f