IPACHTE #►s a.3Harnett County Department of Public Health 28550
Improvement Permit
A building permit cannot be issued with only an Improvement Ppgnit
PROPERTY LOCATION: Rasse(L ls+ceno �j
ISSUED TO: �filo.J �crFFOO—fl SUBDIVISION LOT#
NEW)< REPAIR ❑ EXPANSION ❑
Type of Structure: Y"'IM4, "O,'G lam~' 16�
Proposed Wastewater System Type: W1, C.s"
Projected Daily flow C�® GPD
Number of bedrooms:mber of Occupants: C7 max
Basement ❑Yes '�R No
Site Improvements required prior to Construction Authorization Issuance:
Pump Required: ❑Yet 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. Five years
Permit conditions: ❑ No expiration
Authorized State Agent: HS Date: t0 S SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the iss ther permits. The permit holder is respomible for checking with appropriate governing bodies in meeting Meir requirements. This
site is subject to revocation if the site plan, plat, or the intended use changes. The Improve rmir 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 Permjt)
The construction and installation 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 TO:�a AN S ' �F coC25J PROPERTY LOCATION: nE2 \ l71 MA 1
uoc�� ��� x� SUBDIVISION LOT #
Facility Type: � e+�' � New ❑ Expansion ❑ Repair
Basement? ❑ Yes t:( No Basement Fitx(t)nr�es? 11KC Yes 'R No
Type of Wastewater System' SLC°/e MZ\ < s sy..N Sys Gtr (Initial) Wastewater Flow: "JLd GPD
(See note below, if applicable ❑)
as 0/0, p_ep" Sys - (Repair)
Installation Requirements/Conditions Number of trenches 1
Septic Tank Size s n c2 1�j gallons Exact length of each trench a") O feet
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of: �`6 inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
Pump Requirements: ft. TDH vs. GPM
Conditions:
Trench Spacing: °l Feet on (enter
Soil (over: S inches
(Maximum soil cover shall not exceed
36' above the trench bottom)
Aggregate Depth:
WATER LINES (IN(LUDING 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 spedhed is different homy the type specified on the app/iddon. / accept the cpecildoienc of this permit.
Owner/Legal Representative Signature: Date:
This Construction Authorization is subject to revaation if the site pian, 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 iscnelgict to complian i s of the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent: \ ,1LS Date:
Con ction Authorization Expiration Date:
HTE# 5 - 5 mal^] Permit # a�%s-'E O
Harnett County Department of Public Health
Site Sketch (�
.z� PROPERTY LO(ATON: �SsEcl� y rsSc�c `%�
ISSUED TO: 5�62.(L SUBDIVISION LOT #
Authorized State Agent:
156
1
"'CAN,
1
a,�')0
R.O".r9� D lra rah v
Date:
E' 35 --:N
Department of Environment, Health and Natural Resources
Division of Environmental Health
On -Site Wastewater Section
SOIUSITE EVALUATION
for ONSITE WASTEWATER SYSTEM
Owner: Applicant:
Address: Date Evaluated:
Proposed Facility: Design Flow (.1949): JK)
Location of Site: Property Recorded:
Water Supply: ublic❑ Individual ❑ Well
Evaluation Method Au Boring ❑ Pit [3 cut
Type of Wastewater: Sewage ❑Industrial Process
Sheet:
PropertyID:
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
Mineraloev
.1942
Soil
Wetness/
Color
.1943
Soil
Depth IN.
.1956
S"m
Class
.1944
Restr
Horiz
1-5
G S L
a-�
Sg�Sc.L-
Fn s5�`�'
P535
(6-3p
9
PS
3
0
G s L
yi=n
Ma -) Q
Other Factors (.1946):
Site Classification (.1948):5
Evaluated By:O.
Others Present: f 1`\