IPACMTE# 15, It Harnett County Department of Public Health 28645
Improvement Permit
A building permit cannot be issued with only an`�pravement Permjt
PROPERTY LOCATION: NC�Eoc �p
ISSUED TO: ' 1 d s ss n t SUBDIVISION v o, 6 LOT #
NEWS REPAIR ❑ NSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: SC'9 0(
Proposed Wastewater System Type: Vu m( ld 5 ,anl
Projected Daily Flow: '-N--60 GPD
Number of bedrooms: s"'s Number of Occupants: max
Basement ❑Yes -
Pump Required7.As ❑ No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community "5( Public ❑ Well Distance from well Ltd feet Permit valid for. Five years
Permit conditions_ ❑ No expiration
Authorized State Agent: ��� �, \ a \5 Date: a IG SEE ATTACHED SITE SKETCH
��
The issuance of this permit by the Health Deparlmenl in no way, guarantees the issuance o frt ptmii0. The permit holder is resillonsible for checking with appropriate governing bodies in meeting their requirements. This
site is subject to revocation if the site plan, plat, or the intended we changes. The ImprovementPermit 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, .1957, .1958. and .1959 are incorporated by references into this permit and shall be met. Systems shall be installed in accordance
with the anathed system layout
ISSUED T0: N �� d „G PROPERTY LOCATION: NAa,aG157b`i=0en Do -
SUBDIVISION N-1 c L, v; Cn-aYL LOT # Il
Facility Type: 5f0 Q0"-)0 New ❑ Expansion ❑ Repair
Basement? ❑ Yes �! No Basement Fixtures? ❑ Yes No
Type of Wastewater System** 7seillyG-sION S-,S:Eh (Initial) Wastewater Flow: LT?0 GPD
(See note below, if applicable ❑)
Pum? toe�o (Repair)
Installation Requirements/Conditions Number of trenches 3
Septic Tank Size tIDo 0 gallons Exact length of each trench s0 0 feet Trench Spacing Feet on Center
Pump Tank Size gallons Trenches shall be installed on contour at a Soil Cover: % inches
Maximum Trench Depth of: N'�g inches (Maximum soil cover shall not exceed
(Trench bottoms shall be level to +/-1/4" 36" above the trench bottom)
in all directions)
Pump Requirements: ft. TDH vs. GPM
Aggregate Depth:
Conditions:
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 system type rpeciled is different tom the type spedfed on the application. / accept the specifcadom of this permit
Owner/Legal Representative Signature Date:
This Construction Authonratum is subject to revoca site an, plat. or the intended use changes. The Construction Authorization shall not be tnnsfersed when there is a change in ownership of the site. This
Construction Authorization is sub' ompliance with roviuo laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent: P/r*j Date: 1
Const ' n Authorization Expiration Date: Pi a)
HTE# 1S- 5-3- 0-4 )
Permit # �B6 i t5
Harnett County Departmernt of Ribl is Health
Site Sketch
PROPERTY LOCATON: 'NA IN (Yt D2_
ISSUED TO: SUBDIVISION ti1P� Vv Gn -4LOT #
(,{ tg
Authorized State Agent: 5 of `vC Z roLYS O Date: I_2 I l�
X01, 50
1
A)"t .w
COG1
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: �-� 635 Design Flow (.1949): o i) .
Location of Site: Property Recorded:
Water Supply: _tlfublic❑ Individual ❑ Well
Evaluation Method/ Auger Boring ❑ Pit ❑ Cut
Type of Wastewater: Sewage ❑ 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
Mineralogy
.1942
Soil
Wetness/
Color
.1943
Soil
Depth IN.
.1956
Sapro
Class
.1944
Restr
Horiz
La 3
S3 i%�
V-,, 5'41 44
P3
Q_)0
G rZ) _
to 3k
5�,%su—
9
F� s5T 5P
Pj
• 1'C
v� lP J
Description Initial Repair System Other Factors (.1946):
S m Site Classification (.1948): 4
Available Space( 1945) Evaluated By: L,{
System Type(s)<D\1) <D \ 1- Others Present:
Site LTAR —� 'v