IPACATE# Harnett County Department of Public Health 28522
Il Drovement Permit
A building permit cannot be issued with only an Improvement Permit
cam, PROPERTY LOCATION: FJGr� ��tPs�
ISSUED TO: \,A spAY C-fL SUBDIVISION 7i A 0 c-, o,-:5 M btu Pct... LOT #
NEV'5e REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: SZ --o (:5 ;i--^56
Proposed Wastewater System Type: Soe, 'RK-%>yc.: � 0 N Cara
Projected Daily Flow: GPD
Number of bedrooms: Number of Occupants: max
Basement ❑Yes No
Pump Required: ❑Yes No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community ,,,,Public ❑ Well Distance from well feet Permit valid for: Xfive years
Permit conditions: ❑ No expiration
Authorized State Agent:`��� Date: `$ ��� 1 I`5 SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the issuan ther permits. The permit holder is responsilke 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 TO: "�r4vGQ/ C) PROPERTY LOCATION: l0GGoN V<i
r SUBDIVISION n,5 ( 1 AST O(2.-. LOT # `�LQ
Facility Type: 6 Vr S) (�D-A50 New ❑ Expansion ❑ Repair
Basement? ❑ Yes No Basement Fixtures? ENS 'b<No
Type of Wastewater System** (Initial) Wastewater Flow: 3® GPD
(See note below, if applicable ❑)
Qs"/ o i� v GC t 0 rJ (Repair)
Installation Requirements/Conditions Number of trenches
Septic Tank Size N O �� gallons Exact length of each trench
Pump Tank Size gallons Trenches shall be installed on to ttourr at a
M ' T h Inth of•
uai eft
Pump Reqnts: . TDH vs.
Conditions:
axlmum renc ep
(Trench bottoms shall be level to +/-1/4"
in all directions)
GPM
feet Trench Spacin : Feet on Center
Soil Cover: inches
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 pecified is different from the type speciled on the application. / accept the specilcationr 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 change in ownership of the site. This
Construction Authorization is su ' fiance with ovisions of the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit. SEE ATTACHED SITE SKETCH
Authorized State Agent: KGs Date: q 75
truction Authorization Expiration Date: - M I��
HTE# �5- 5 `3(;%Tl-
Permit # a` 5
Harnett County Department of Public Health
Site Sketch
PROPERTY LOCATON: 10 �G_ o � ��
ISSUED T0: �� ,€G AG �+� SUBDIVISION -�y.m n4' , ,e,R, LOT #9� yZ�)
Ci
Authorized State Agent: 'T01-4)Date: Jd'�
X14
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: ;3 Design Flow (.1949):3b���'
Location of Site: Property Recorded:
Water Supply: Public❑ Individual ❑ Well
Evaluation Method NA Boring ❑ Pit ❑ Cut
Type of Wastewater: Sewage ❑ 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
Mineralogy
.1942
Soil
Wetness/
Color
.1943
Soil
Depth (IN.)
.1956
Sapro
Class
.1944
Restr
Horiz
§,
Description Initial Repair System Other Factors (.1946):
System Site Classification (.1948):5
Available Space(. 1945) Evaluated By: U !,
System Type(s) S ° Y Others Present:
Site LTAR d