IPAC RHTE# Harnett County Department of Public Health 29823
Improvement Permit
A building permit cannot be issued with only an ImYov
PROPERTY LOCATION: cepnt PerM
T R o
ISSUED TO: F4 E R ! k D2� SUBDIVISION LY r t G oo w t �j LOT #
NEWX REPAIR ❑ NSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: 5VD Lg0
Proposed Wastewater System Type: Q.5' o Eou G CPQ W 5ys,a
Projected Daily Flow: 360 GPD
Number of bedrooms: 3 Number of Occupants: to max
Basement ❑Yes 'X No
Pump Required: ❑Yes ❑ No ay be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community ❑ Public A Well Distance from well 1 CS C)' feet Permit valid for. Five years
Permit conditions: ❑ No expiration
Authorized State Agent:: "M5 Date: 1151 rt SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Departmem m no way guarantees uance of other permits. The permit holder is responsible for checking with appropriate governing bodies in meeting their requirement. This
site is subject m revocation if the site plan, plat, or the intended use changes. The Im wnginent Permit shall not be affected by a change in ownership of the site. This permit is subject to compliance with the provision 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 requirement of Rules .1958, .1951, .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 attacked system layout 9
ISSUED TO: xP<Z�'— PROPERTY LOCATION: S /4D5 Y°1T L n
SUBDIVISION l y� t Goo a t LOT #
Facility Type: SF9 (q O'KSCJa New ❑ Expansion ❑ Repair
Basement? ❑ Yes No Basement Fixtures? ❑ Yes ❑ No
Type of Wastewater System" _6c PC—oucRtvsJ S7i6-sSm, . (Initial) Wastewater Flow: 360 GPD
(See note below, if applicable ❑)
e
Conditions:
Trench Spacing: Oj Feet on Center
Soil Cover. 6--a,L} inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
Aggregate Depth:
WATER LINES (IN LUDING IRRIGATION) MUST BE IOFF. 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: / andemand the system type specfled is different from the type specfled on the application. / accept the fpecifcadonr of this permit.
Uwner/Legal Representative Signature: Date:
This construction Authorization is to revoation if the site plan, plat, or the intended use changes. The construction AuAomation shall not be transferred when there is a change in ownership of the site. This
construction Authorization is tt to cam " a ovisions of the laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent: Wer Date: I S
Constru 'on Authorization Expiration Date: 1 5
(Repair)
Installation Requirements/Conditions
Number of trenches 1
Septic Tank Size 1 0 o v gallons
Exact length of each trench 1 15 feet
Pump Tank Size gallons
Trenches shall be installed on contour at a
Maximum Trench Depth of.- i�Z"3Co inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
Pump Requirements: h. TON vs.
GPM
Conditions:
Trench Spacing: Oj Feet on Center
Soil Cover. 6--a,L} inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
Aggregate Depth:
WATER LINES (IN LUDING IRRIGATION) MUST BE IOFF. 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: / andemand the system type specfled is different from the type specfled on the application. / accept the fpecifcadonr of this permit.
Uwner/Legal Representative Signature: Date:
This construction Authorization is to revoation if the site plan, plat, or the intended use changes. The construction AuAomation shall not be transferred when there is a change in ownership of the site. This
construction Authorization is tt to cam " a ovisions of the laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent: Wer Date: I S
Constru 'on Authorization Expiration Date: 1 5
HTE# 15-5 36S114 -
Permit # a�lgj
Harnett County Department of Public Health
Site Sketch
PROPERTY LOCATON: QY2O5
ISSUED TO: G »A SUBDIVISION LOT #
Authorized State Agent: (tt�T, Date: (1 S)y
--7y5
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IL
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Q1 W
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Department of Environment, Health and Natural Resources
Division �f Environmental Health
On -Site Wastewater Section
SOIL/SITE EVALUATION
for ON-SITE WASTEWATER SYSTEM
Owner: Applicant:
Address: Date Evaluated: `7/G /T
Proposed Facility: Design Flow (.1949):
Location of Site: ,�/ Property Recorded:
Water Supply �� 12 Public❑ Individual ❑ Well
Evaluation Method: Auger B ng ❑ Pit ❑ Cut
Type of Wastewater: Sewage ❑ Industrial Process
Sheet:
Property ID:
Lot #:
File #:
Code:
Property Size:
❑ Spring
❑ Mixed
❑ Other
P
R
O
F
1
SOIL MORPHOLOGY
OTHER
L
.1940
Landscape
Horizon
.1941
PROFILE FACTORS
E
#
Position/
Slope%
Depth
(In.)
Structure
Structure/
.1941
Consistence
.1942
Soil .1943 .1956
Wetness/ Soil
Profile
Texture
Minaalogy
Sapm
Color D th IN. Class
ReRestr Class
Hol & LIAR
C)-
Glzf
I.�
Description
Initial
Repair System Other Factors (.1946):
Available apace (.1945)
SystemT
System
Site Classification
(.1948):.r
Evaluated By:
Site LTAR
e(s)
n _
Others Present: