IPAC RHTE#�� J—�UIL Harnett County Department of Public Health 29110
Improvement Permit
A building permit cannot be issued with only aLIIm.Provement Pe it
PROPERTY LOCATI N: 11rvc':N
ISSUED TO: S� AN c $ v ntO Egy SUBDIVISION �p,SS o f� 5 OI.Si LOT #
NEW*tK 5RE�PAI 11—4XPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure:
Proposed Wastewater System System Ty�o o\Jc'- No" T T�
Projected Daily Flow: `-,IS Ci, (5 GPD
Number of bedrooms: "3 Number of Occupants: C,_max
Basement ❑YesIto
Pump Required: []YesNo May be required based on final location and elevations of facilities
Type of Water Supply: ElCommunity Public ❑ Well Distance from well 1 feet Permit valid for. / Five years
Permit conditions: ❑ No expiration
Authorized State Agent: Date: 11 1 13116 SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the rs of other permits. The permit hold— erTresponsible for shacking with appropriate governing bodies in meeting their requirements. This
site is subject to revocation 4 the site plan, plat or the intended use changes. The Impro7liftpt Permit shall not be affected by a change in ownership of the site. This permit is subjea to compliance with the provisions of
the taws and Rules for Sewage Treatment and Disposal and to conditions of this permit.
Construction Authorization
Required for Buildin¢ Permit
The construction and installation requirements of Rules .19So, .1957, .1954, .1955, .1956, .1957, .1958. and .1959 are incorporated by references into this permit and shall be met. Systems shall be installed in amrdana
with the attached system layout
ISSUED TO: PROPERTY LOCATION: S 1r- 6 \cp
SUBDIVISION pA1S0 na N LOT # \43
Facility Type: SCrO(LA � c51� X, New ❑ Expansion ❑ Repair
Basement? ❑ Yes --.'&, No Basemf fit Fixtures? ❑Yes N�
Type of Wastewater System" a l o RGoyCrCv&N SSEsn (Initial) Wastewater Flow: GPD
(See note below, if applicable ❑) e
Conditions:
Trench Spacin : Feet on Center
Soil Cover. 3 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 SEPTI( 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 grtem type sizedhed is different from the type specified on the application. / accept the specifiwiom of this permit
Owner/Legal Representative Signature: Date:
This Construction Authonzats a to revomtion if the site 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 Authorizai thevitpaisions of the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent "� Date: %
nstruction Authorization Expiration Date:
(Repair)
Installation Requirements/Conditions
Number of trenches S
Septic Tank Size 10tn"O gallons
Exact length of each trench SACS feet
Pump Tank Size gallons
Trenches shall be installed on contour at a
Maximum Trench Depth of-. 1� 30 inches
(Trench bottoms shall be level to +/.I/4"
in all directions)
Pump Requirements: h. TDM vs.
GPM
Conditions:
Trench Spacin : Feet on Center
Soil Cover. 3 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 SEPTI( 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 grtem type sizedhed is different from the type specified on the application. / accept the specifiwiom of this permit
Owner/Legal Representative Signature: Date:
This Construction Authonzats a to revomtion if the site 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 Authorizai thevitpaisions of the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent "� Date: %
nstruction Authorization Expiration Date:
HTE# la - 5 �� U631 (L,
Permit # a M1 --
Harnett County Department of Public Health
Site Sketch
PROPERTY LO(ATON: nl 66N vu)
ISSUED TO: SUBDIVISION 'V o) Y-, LOT # 1143
Authorized State Date: >> 31 4
c
G vN'iR2 C7
`3 i
Department of Environment, Health and Natural Resources
Division of Environmental Health
On -Site Wastewater Section
SOIL/SITE EVALUATION
for ON-SITE WASTEWATER SYSTEM
Sheet:
Property ID:
Lot #:
File #:
Code:
Owner: Applicant:
Address: Date Evaluated:
Proposed Facility: -3 j2 Design Flow(. 1949): 360�c_' Property Size:
Location of Site:Property Recorded:
Water Supply: Public❑ Individual ❑ Well ❑ Spring
Evaluation Method -0 Auger Bo 'fig ❑ Pit El cut
Type of Wastewater: [i] Sewage ❑ Industrial Process ❑ Mixed
❑ Other
P
R
O
F
I .1940
L Landscape
E Positiond
# Slope%
SOIL MORPHOLOGY
.1941
Horizon
Depth .1941 .1941
(In.) Structure/ Consistence
Texture
OTHER
1 PROFILE FACTORS
Profile
Class
& LTAR
1942
Soil
Wetness/
Color
.1943
Soil
D Ih �'.
.1956
Sapro
Class
.1944
Restr
Horiz
GMineralo v
Description Initial Repair System Other Factors (.1946):
S ste Site Classification (.1948)f 5
Available Space .1945) Evaluated By)C)
System T e(s) S r
Site LTAR Others Present: —
- 6 ..
r ->a N(V kz'' _)U