IPACHTE# NlHarnett County Department of Public Health
Improvement Permit 26388
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: ®o c,5 V-Z
ISSUED T0: y''cN Cass 2v G~lOct SUBDIVISION Vma&N1 SQ-5 ?-\QGE LOT # L t
NEW' REPAIR ❑ E NSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: 51'2 ~ta
Proposed Wastewater System Type: 9-r-V u c.;.5 10 Projected Daily Flow: "'1 GPD
Number of bedrooms: L-\ Number of Occupants: max
Basement ❑Yes X No
Pump Required: ❑Yes '<?q No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community E, Public ❑ Well Distance from well 10 d feet Permit valid for: Five years
Permit conditions: ❑ No expiration
Authorized State Agent:: Date: \1 \ctl 1\ SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the iss c~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.
ISSUED TO: 0 PROPERTY LOCATION: ~D oca5 R4D
SUBDIVISION ) QZ73 9p;:~, Pte, LOT # _1
facility Type: '56 New ❑ Expansion ❑ Repair
Basement? ❑ Yes No Base!ment Fixtures? F-1 Yes No
Type of Wastewater System** ~-~°r0 Qr-.vur'~7 teJ 0 (Initial) Wastewater Flow: INI0 GPD
(See note below, if applicableXJ)
v
~ to ~~v~rctd~ Sys-, ~ (Re air)
Installation Requirements/Conditions
Septic Tank Size 1o0`:3 gallons
Pump Tank Size gallons
Pump Requirements: ft. TDH vs.
Conditions:
P
Number of trenches 5
Exact length of each trench 50 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: 1 inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
Aggregate Depth:
inches below pipe
inches above pipe
inches total
WATER LINES (IN(LUDING IRRIGATION) MUST BE ]OFT. FROM ANY PART OF SEPTIC SYSTEM OR REPAIR AREA.
NO UTILITIES ALLOWED IN INITIAL OR REPAIR DRAIN FIELD AREA.
**If applicable: l understand the system type specified is different from the type specified on the application. l accept the spec/dcations of thi permit.
Owner/Legal Representative Signature: Date:
This Construction Authorization issubject to revocation 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 Authorization is sou ' ct to compliast~ rov`s of the laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit. SEE ATTACHED SITE SKETCH
Authorized State Agent: P-6\\~ Date: S
uction Authorization Expiration Date: v &L
HTE# aI s - °asILl3 Permit # "-S3 s
0~ I
)5 0~
E~~ U G`~--l 5 Erz Q~j I--N
Deportment of Environment, Health and Natural Resources
Division of Environmental Health
On-Site Wastewater Section
SOIIJSM EVALUATION
for ON-,SITE WASTEWATER SYSTEM-
Sheet:
Property ID:
Lot
File
Code:
Owner Applicant:
Address: Date Evaluated 11 ,,i ~r
Proposed Facility: mz xG C, o,,-i Design Flow (.1949): 1--o 0 J r: Property Size:
Location of Sits Property Recorded:
Watet Suppig Public ❑ Individual ❑ Well C] Spring ❑ Other
Evaluation Method: Auger Boring ❑ Pit Cut
Type of Wastewater. Sewage ❑ Industrial Process C3 Mixed.
P
R
O
F
SOIL MORPHOLOGY OTHER
1
.1940
.1941 PROFtLB FACTORS
L
Landsm"
Horizon
11942
9
Poeitiow
Depth
.1941 .1941 Soil 1943 .1956
1944 ftmi
Slops %
00
.
stuctmw Comikem wetnad soil Sepre ReAr Ctus
Taxh n Minenlo Color 1M
CIA= Hans. & L?,411
R
15 5 vG"n Q.~~ ,S
L
1S iv,
~8-~- &61~- 7s1
y ~ .
I.;',, I. .
nepar ayamm Other Factors (.1946)
Site CluMcation (.1948)
Evaluated By: r~5
Others Premt: 9~,-