IPACHTE# 1 !5j_3 Harnett County Department of Public Health
Improvement Permit 2 6 4 0 9
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION
ISSUED TO/J i /J Y /Z+ S~ G 4,x,2 l SUBDIVISION LOT # 4
NEW 4 REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: I)LO $A
Proposed Wastewater System Type: ZS"Z' tS
Projected Daily Flow: 3 GPD
Number of bedrooms: Number of Occupants: max
Basement ❑Yes LJ No
Pump Required: ❑Yes ❑ No IXMbe required based on final location and elevations of facilities ~/Type of Water Supply: ❑ Community blic 11 Well Distance from well feet Permit valid for L/ Five years
Permit conditions: ❑ No expiration
Authorized State Age G A:--1 Date: Z ° Z / / SEE ATTACHED SITE SKETCH
The issuance of this permit by Health Department in no way guarantees the issuance of other permits. The permit holder is responsible for checking with appropriate governing bodies in meeting their requirements. This
site is subject to revocation i e 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 T0: - cf /ZhY" C/ ff PROPERTY LOCATION: Gl ri -CIAUZS~ r4,6
SUBDIVISION LOT # Z
Facility Type: 1' -1- EY New Expansion ❑ Repair
Basement? ❑ Yes LEI No Basement Fixtures? ❑ Yes ~No
Type of Wastewater System** 21F
.,k ~b 1)C-4Z«-O Ai,!5 (Initial) Wastewater Flow: °34x--'3 GPD
(See note below, if applicable /yl
?e;Z60 ° (Repair)
Installation Requirements/Conditions Number of enches 7-
Septic Tank Size /000 gallons Exact length of each trench 2 0 feet Trench Spacing: ~ Feet on Center
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of: Z q inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
Pump Requirements: ft. TDH vs. GPM
Conditions:
Soil Cover: 4 inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
inches below pipe
Aggregate Depth: inches above pipe
17- inches total
WATER LINES (INCLUDING IRRIGATION) MUST BE LOFT. FROM ANY PART OF SEPTIC SYSTEM OR REPAIR AREA.
NO UTILITIES ALLOWED IN INITIAL OR REPAIR DRAIN FIELD AREA.
**If applicable: / understand 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 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
Lonstruction Authorization is subject to compliance with the provisions of the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit IEE Al IACHED SITE SKETCH
Authorized State Agent Date:
Construction Authorization Expiration Date: z
HTE# Z-5U
Permit #
Harnett Connty ]Department of Public Health
Site Sketch
PROPERTY LOCATW jSliq J-3~ /Z4C$
ISSUED TO: % C SUBDIVISION LOT # e---2
Authorized State Ag Date: Z 2 "
61
`2.1 d '
Depawnent of Enviromnent, Health and Natural Resources Sheet:
Division of Environmental Health Property ID:
On-Site Wastewater Section Lot e
Cam;
SOQJSITE EVALUATION Files
for ON-SITE WASTEWATER SYSTEM
Owner. Applicant: Z 5--P 3,3
Address: Date Evaluated:
Proposed Facility: f* •s, M Design Flow (.1949): 3 6o Property Size:
Location of Site. Prapesriy Recorded:
Wateslt Suppty [~~ublic ❑ Ulividual ❑ Well ❑ Spring ❑ Other
Evaluation Mdho& tiger Boring ❑ Pit cut
Type of Wastewatesr. Sewage ❑ Industrial Process Mite d
P
R
O
F
SOIL MORPHOLOOY
OTHER
I
.1940
.1941
PROFU FACTOA3
L
LXWSaapt
Horizon
.1941
E
H
Positiod
Slope %
Depth
([a)
.1941 .1941
St
W
Sail
.1943 .1956
.1941 ?M11%
rastW
Condetem
Ted Mtttxtlo
Wettest!
Color
Sail Sepre
Re* clan
IN, Chq
Hons. ALTAR
j
c r
L t -ILL-L2 JC 45/'a
5 ` q B J'0 _ I fi7L^r'/ < 17 1f " ~Z6 ,A
77- 30,- 3Z
32 y c-cry 1- ~1ALI's.c~' 32
01,~5 -
zc,
L ' ' I~ P
3Z '
h~J__VM_5,P" a it
v
6
C xlv ~i -Z`f 5Lx
Zq - S~_ ct _ r-A W-_S . Id fib"
caner Factors 1946X
Site Classiflcadon (.1948k Vf)
Evahuated By:
Others presemt:
n
50