IPAC RHTE# ®133 R ariiett County Department o Public dealth 25039
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
P'M'iI-Z4 kOmr-- coPROPERTY LOCATION: CaEE~SV~Z, £ G,~vCLGY\ Zo
ISSUED TO: SUBDIVISION -Ye" i-N LOT # I~_
NEW REPAIR ❑ EXISION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: 5a x z1
Proposed Wastewater System Type: aS"Ze; 'Repuc. N0 N SvS~E~
Projected Daily Flow: 3fa O GPD
Number of bedrooms: Number of Occupants: -Q~, max
Basement ❑Yes X No
Pump Required: ❑Yes ❑ No May be required based on final location and elevations of facilities
Type of Water Supply: El Community " Public El Well Distance from well trio feet Permit valid for: Five years
Permit conditions: _ ❑ No expiration
Authorized State Agent:: % Date: \O N I b<b SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the issua of other permits. The permit holder is responsible for 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, .1952, .1954, .1955, .1956, .1951, .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. Co -N i3'
ISSUED TO: ~ PROPERTY LOCATION: G?k,-ys'4 N C UQ-C-y' R lc~
SUBDIVISION y ~y L-, N Oates LOT # 19
Facility Type: s~9 rxs~ 5~"'~~ New ❑ Expansion ❑ Repair
Basement? ❑ Yes No Basement Fixtures? ❑Yes No
Type of Wastewater System** css ~cf N S`ISrErr\ (Initial) Wastewater Flow: GPD
(See note below, if applicable
RE-Ouc:Ssnrs SySrE~r~n (Repair)
Installation Requirements/Conditions
Septic Tank Size i, O gallons
Pump Tank Size gallons
Pump Requirements: ft. TDH vs.
Conditions:
Number of trenches I
Exact length of each trench 2~3a feet
Trenches shall be installed on contour at a
Maximum Trench Depth of: inches
(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:
inches below pipe
inches above pipe
inches total
**If applicable: /under fond the system type specified is different from the type specified on the application. / accept the .specifications of this permit.
Owner/Legal Representative Signature: Date:
This Construction Authorization is subject to re if the site pla , lat 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 is subject tocompliance witffgr "tithe s and Rules for Sewage Treatment and Disposal and to the conditions of this permit. SEE ATTACHED SITE SKETCH
01
08
Authorized State Agent: Date: L
Constr ion Authorization Expiration Date: Lo t ?l
R,~-- v)-s.0 ,)CI,,
\
H T E # C`~ ' S ®ap~ 63 9. Permit #
Harnett County Department of Public Health
Site Sketch
ISSUED TO:
Authorized State Agent:
PROPERTY LOCATON: -Exs~t~ zZ E Cia y 2G~
'eloea,,t\f= SUBDIVISION JeyL,~ ®a.`~s LOT # 19
Q S ~¢L,v fn ate: 10 1 4) 6-
c~„~v, ~ ~ 41 `l ohs
r
,a,:1-3 i
Division of Environmental Health vvv
On-site Wastewater Section
SOIL/SITE EVALUATION
for ON-SITE WASTEWATER SYSTEM
Owner:
Address:
Proposed Facility: 3 d%~-OrL4 j c I,~ mm Design Flow (.1949):
Location of Site:
JI ICCI.
Property ID:
Lot
File
Code:
Applicant:
Water Supply: Public Individual Well
Evaluation Method: Auger Boring [ J Pit
Type of Wastewater: "'Y Sewage Industrial Process
Date Evaluated:
Property Size: J
Property Recorded:
Spring [ J Other
[ J Cut
[ J Mixed
P
R
o"
F
SOIL MORPHOLOGY
.1941
OTHER
PROFILE FACTORS
1
L
E
#
.1940
Landscape
Position/
Slope%
Horizon
Depth
(IN.)
1941
Structu
re/
Texture
A941 '
Cons;stence
Mineralog
.1942
Soil
Wetness/
Color
1943
Soil
DePth(lN.)
.1956 '
Sapra'
Class
JH
TAR
1
~jCc) L
6
0-)2-)
C
Description
Initial System
Repair System
Available Space (.1945)
V7-
-7
System Type(s)
$6a/oQC-)
c caa
ISite LTAR
Lti
)
Evaluated By: 0\
Others Present:
Other Factors (.1946): _
Site Classification (.1948): 9.5