IPACHTE# Harnett County Department of Public Health 28622
hDrovement Permit
A building permit cannot be issued with only an Im rovement Permit
PROPERTY LOCATION:TZi �9
ISSUED TO: SUBDIVISION LOT #
NEW'4 REPAIR ❑ XPANSION Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: � Pa N 1 �0 E �T6 "� 6J
Proposed Wastewater System Type: 15°!, vC5 I d
Projected Daily Flow: bc3 GPD
Number of bedrooms: Number of Occupants: C max
Basement ❑Yes11
Pump Required: ❑Yes No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community X Public ❑ Well Distance from well 10O feet Permit valid for. Five years
Permit conditions: ❑ No expiration
Authorized State Agent: Date: S SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the issuano. dimer permits. The permit holder u res onTor 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, .1951, .1954, .1955, .1956, .1951, .1956. and .1959 are incorporated by references into this permit and shall be met Systems shall be installed in accordance
with the atuched system layout
ISSUED T0: C�c' n, LS Stay PROPERTY LOCATION: —CN '/ QS)
/ SUBDIVISION LOT #
Facility Type: t le, i� vc�6 <i�'�6� New ❑ Expansion ❑ Repair
Basement? ❑ YesNo Bazement fixturgs�p ❑ es �'No
Type of Wastewater System** CZ7 l �GoyC.<i0.v (Initial) Wastewater Flow: 7'6O GPD
(See note below, if applicable ❑)
aS°lci K–GJ • SyS . (Repair)
Installation Requirements/Conditions Number of trenches 'Qt,
Septic Tank Size S OOo gallons
Pump Tank Size gallons
Pump Requirements: ft. TDH vs.
Conditions:
Exact length of each trench 1) O feet
Trenches shall be installed on contour at a
Maximum Trench Depth of. 1inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
GPM
Trench Spacing: Feet on Center
Soil Cover. inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
Aggregate Depth:
WATER LINES (INCLUDING IRRIGATION) MUST BE IOFT. 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 .),stem type specified is difiereort from the type spedfed on the applicadon. / accept the specidcatiom of thin permit
construction Authorisation is
Authorized State Agent:
Date
plat, or the intended use changes. The construction Authorization shall not be transferred when then i
of the laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit
X15 Date: 1�
CoWftction Authorization Expiration Date: a ?
SEE ATTACHED SITE SKETCH
HTE# � 5 .- cJ _ 3-7 S � Permit # aq 6 3�D-
Harnett County Department of INiblic Health
Site Sketch nn
PROPERTY LOCATON: i U�
ISSUED T0: ��' �2���6 yE i SUBDIVISION LOT #
Authorized StateAgent:\\\e\l� \'^ � r15 �1 vGe Sots ate: % 2 1y I i
76
t6
oar --,( C
Department of Environment, Health and Natural Resources
Division of Environmental Health
On -Site Wastewater Section
SOILISITE EVALUATION
for ONSITE WASTEWATER SYSTEM
Owner: Applicant:
Address: Date Evaluated:
Proposed Facility: Design Flow (.1949):]
Location of Site: Property Recorded:
Water Supply: Public❑ Individual [I Well
Evaluation Metho�Au Boring ❑ Pit ❑ Cut
Type of Wastewater: ewage ❑ 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.)
SOH, MORPHOLOGY
.1941
OTHER
PROFILE FACTORS
Profile
Class
& LTAR
.1941
Structure)
Texture
.1941
Consistence
Mineralogy
.1942
Soil
Wetness(
Color
.1943
Soil
IN.
.1956
Sapro
Class
.1944
Restr
Horiz
ci
�� 3ii
S3xsv1.
� 55
`'S
IP
we -
Description Initial R air System Other Factors (.1946) -
Sys
to Site Classification (.1948):
Available Space( 1945Evaluated By:Q'�
System Type(s) n Others Present:
Site LTAR I Lit,