IPACHTE# 15-5-"3-7141 S Harnett County Department of Public Health 28618
Improvement Permit
A building permit cannot be issued with only an Improvement Pent
\' `\ \ PROPERTY LOCATION:\nFyTX �E
ISSUED TO: Y�6taV ea' 1�OSrn s.4 C' SUBDIVISION LOT #
NEW'% REPAIR ❑ EKPAF SION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure:
Proposed Wastewater System Type: • fl s G >J S Y5 i
Projected Daily Flow: 3 GPD
Number of bedrooms: � Number of Occupants: max
Basement ❑Yes -I<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 \ f)O feet Permit valid for.Five years
Permit conditions: ❑ o expiration
Authorized State Agent: :!� `\;Ci,;:2100
The issuance of this permit by the Health Depamnem in no way guarantees a
sire is subject to revocation if the site plan, plat or the intended use changes. The
the laws and Rules for Sewage Treatment and Disposal and to conditions of this permit..
Date:
SEE ATTACHED SITE SKETCH
of other permim The permit holder is re/ponsible for checking with appropriate governing bodies in meeting their requirements. This
rent Permit shall not be aliened by a change in ownership of the site. This permit is subject to compliance with the provisions of
Construction Authorization
Required for Buildine Permit
The conswction and installation requirements of Rules .1958, .1952, .1954, .1955, .1956, .1957, .1958. and .1959 are incorporated by references into this permit ad shall be net. Systems shall be installed in accordana
with the attached system layout
ISSUED TO: "A Lv.N6� �UsnES I v c PROPERTY LOCATION: vAlal
SUBDIVISION P t Ts Wr ,mss C-00-01 -a G LOT #
Facility Type: S �G "53� New ❑ Expansion ❑ Repair
Basement? ❑ Yes nx�,No Basement Fixes? ElYes > I o
Type of Wastewater System" Q.S °10 ovcs, i 0 y -J (Initial) Wastewater flow: 3� � GPD
(See note below, if applicable ❑)
cA n,P 1 o Z'v/0 (Repair)
Installation Requirements/Conditions Number of trenches
Septic Tank Size 1 gallons
Pump Tank Size gallons
Pump Requirements: fL TDH vs.
Conditions:
Exact length of each trench 3 b CS feet
Trenches shall be installed on contour at a
Maximum Trench Depth of: ok O inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
GPM
Trench Spacing: Feet on Center
Soil Cover. R 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 r}rtem type rpecifed It different from the type specified on the application. / accept the rpecilcatiezr of this permit
Owner/Legal Representative Signature: Date
This construction Authorization is so le vocation if the sire 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 Authomation is sutLeiaktor compliance e is ions of the laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent: 9415 Date: 1i o
�tlruction Authorization Expiration Date: 1 a 13 U 10
HTE# 15 -5=3-) L-; S' Permit # aUlq
Harnett County Department of Public Health
Site Sketch n
PROPERTY LOCATON: VSA CZFDo C6—
ISSUED TO: ,C,
r( SUBDIVISION LOT # a8
Authorized State Agent � �pLw� TUL��O > Date: %�1301\J-
0 cop
J
urop
a -Ca
Department of Environment, Health and Natural Resources
Division of Environmental Health
On -Site Wastewater Section
SOIUSITE EVALUATION
for ON-SITE WASTEWATER SYSTEM
Owner: Applicant:
Address: Date Evaluated:
Proposed Facility:`� gp� ^ Design Flow (.1949): 3(,o E
Location of Site: Property Recorded:
Water Supply: Public❑ Individual C1 Well
Evaluation Method: �l4uPring [3 Pit F1 cut
Type of Wastewater: `w Sewage ❑ Industrial Process
Sheet:
Property ID:
Lot #:
File #:
Code:
Property Size:
❑ Spring
❑ Mixed
❑ Other
P
R
OOTHER
F
1
L
E
#
.1940
Landscape
Position/
Slope%
Horizon
Depth
(In.)
SOIL MORPHOLOGY
.1941
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
6_
s3�z ccz
�rL
Description Initial Repair System Other Factors (.1946):
S ste Site Classification (.1948): P.7
Available Space (. 1945) Evaluated By:
System Te(s) O-s"iy $.f Others Present: -.
Site LTAR '