IPACHTE# 1Harnett County Department of Public Health 28539
Improvement Permit
A building permit cannot be issued with only an Improvement tit Pe
PROPERTY LOCATION: RossFs,. ti Jt +4 n"
ISSUED TQ: ?S2sAN S �aF�F0C1� SUBDIVISION Evt_L LOT #
NEWA REPAIR ❑ E) ANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: M�,r, )4en+F:- n,' "<0
Proposed Wastewater System_ Type: W10 Vcv, 0•uaf-(N
Projected Daily Flow: GPD
Number of bedrooms: 3 Number of Occupants: max
Basement []YesNo
Pump Required: []YesNo ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community X Public ❑ Well Distance from well ��• feet Permit valid for. five years
Permit conditions•. R _ ❑ No expiration
Authorized State Agent:_ � Fz Date: 'I SEE ATTACHED SITE SKETCH
The iuuana of this permit by the Health Department in no way guarantees the is 1 other permim The permit holder is !!N for checking with appropriate governing bodies in meeting their requirements. This
site is subject to revocation if the site plan, plaC or the intended use changes. The Improve ent 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 imeallation requirements of Rules .1950, .1957, .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: gsLta� SiPE'4 OftA PROPERTY LOCATION: A...6,f - Mflti
SUBDIVISION EZZs M - - L LOT #
Facility Type: T) Pj, N �ios�E�`"t �� Oi� New ❑ Expansion ❑ Repair
Basement? ❑ Yes '�kNo Basement Fixtures? ❑ Yes �<No
Type of Wastewater System** 3 -so/ o " 6Tv 'S 15-7"epr\ (Initial) Wastewater Flow:3� GPD
(See note below, if applicable ❑) o
1S 10
Y,.Gp Je N o" (Repair)
Installation Requirements/Conditions
Number of trenches 3
Septic Tank Size L O O d gallons
Exact length of each trench feet
Pump Tank Size gallons
Trenches shall be installed on contour at a
Maximum Trench Depth of:%�_ inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
Pump Requirements: ft. TDM vs.
GPM
Conditions:
Trench Spacing: Feet on Center
Soil Cover. 4 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: / ondeatand the tyttem type tpedffed it different from the type speared on the application. / accept the rperilrationr of this permit
Owner/Legal Representative Signature:
construction Authorization is
intended use changes. The Consrmmon Authorization shall not be transferred when
and Rules for Sewage Treatment and Disposal and to the conditions of this permit
Authorized State Agent —%z�� Date: g
Cons ran Authorization Expiration Date:
Date:
SEE ATTACHED SITE SKETCH
HTE# iS'S=370`T$ Permit # x.1521�
Harnett Counter Department of 1--�iblie Health
Site Sketch
PROPERTY LO(ATON: T
ISSUED TO: A J ST9-WMCU0 SUBDIVISION Q V\ k, G LOT #
Authorized State Agent: C6 Date: �3
Rp566(L Q t��F,,t (Zp
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: Z � -0 Design Flow (.1949): 3lOs�
Location of Site: Property Recorded:
Water Suppl ublic❑ Individual ❑ Well
Evaluation Metho . A r ori ❑ 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
Minemlogy
.1942
Soil
Wetness/
Color
.1943
Soil
Depth IN.)
.1956
Sapro
Class
.1944
Restr
Horiz
L
3
O
Q5 5
U Ng1JO
71 50);e
1 cL
P'
Description Initial Repair System Other Factors (.1946):
S ste Site Classification (.1948):
Available Space(. 1945) Evaluated ByCb(
System Type(s) 2— Others Present: B i
Site LTAR