IPACHTE# ► _5 a~1 Harnett County Department of Public Health
hDrovement Permit 26455
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: M tic.cao ) 0V&Z'
ISSUED T0: C U ~n4E~LLt~s~sp ~OM~g SUBDIVISION _'TSN1.f-- s pt..t~.,cE. LOT # 2`S
NEW REPAIR Ex SION E]
Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: 5 'FQ S3^
Proposed Wastewater System Type: ~CoUC-:1~N Sy5
Projected Daily flow: 3G ® GPD
Number of bedrooms: 3 Number of Occupants: Ca max
Basement ❑Yes No
Pump Required: ❑Yes 'ZQNo ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community Public ❑ Well Distance from well t60 feet Permit valid for Five years
Permit conditions: ❑ No expiration
Authorized State Agent:: W` ~ QE-i"5 Date: '°tI N\ SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees t stance 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 movement 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: C,uM9V5q_V"r'Sra "omES PROPERTY LOCATION: `M e,¢O 1owG ~
SUBDIVISION Vj"GV_- N ?'P'r_E LOT #
Facility Type: S F ® (5:: x 53~ New ❑ Expansion ❑ Repair
Basement? ❑ Yes 'iRl No Basement Fixtures? ❑ Yes XNo
Type of Wastewater System** QS°jo \2E s~uc.-C a N `~y Gr^ (Initial) Wastewater Flow: -SG 0 GPD
(See note below, if applicable
1ZCbQcsS\1.a ~y5iErn (Repair)
Installation Requirements/Conditions Number of trenches t
Septic Tank Size L;nC) d gallons
Pump Tank Size gallons
Pump Requirements: ft. TDH vs.
Exact length of each trench 10- o feet
Trenches shall be installed on contour at a
Maximum Trench Depth of. S $"~'~1 inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
GPM
Trench Spacing: Feet on Center
Soil Cover: 6inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
inches below pipe
Aggregate Depth: inches above pipe
Conditions: S -+5-T L "o u S t v B G y ~2~v~ FA &-L Lc, inches total
WATER LINES (IN(LUDING IRRIGATION) MUST BE 10FT. 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. / accept the specipcations of this permit.
Owner/Legal Representative Signature: Date:
This Construction Authorization is subject to revocation kthe 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 su~'ect to compliance tk th visions of the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit.
SEE ATTACHED SITE SKETCH
Authorized State Agent: QL-~ ~Df vyCw_ "Coj1~ Date: al-i
l~
Construction Authorization Expiration Date: 9 16
boa'
®OUgLIca ~ s tiv~
Department of Environment, Health and Natural Resources
Division of Environmental Health
On-Site Wastewater Section
SOIIJSITE EVALUATION
for ON-SITE WASTEWATER SYSTEM
Owner: Applicant:
Address: Date Evaluated: 11.7 e
Proposed Facility: 3 zq6 cr. Design Flow (.1949): a
Location of Site: Property Recorded:
Water Supply: 'UNblic ❑ Individual ❑ Well
Evaluation Method: uger Boring ❑ Pit ❑
Type of Wastewater: EK Sewage ❑ Industrial Process ❑
Sheet:
Property ID:
Lot
File
Code:
Property Size:
❑ Spring ❑ Other
Cut
Mixed
P
R
O
F
I
1940
OIL MORPHOLOGY
.1941
THER
PROFILE FACTORS
L
E
#
Landscape
Position/
Slope %
Horizon
Depth
(In.)
.1941
Structure/
Texture
.1941
Consistence
Mineralogy
.1942
Soil
Wetness/
Color
.1943
Soil
DeA IN.
.1956
Sapro
Class
.1944
Restr
Horiz
Profile
Class
& LTAR
F CL
C
'4
Description
Initial
svstmw
Repair System
Other Factors (.1946).
Site Classification (
1948):
Available Space .1945
.
Evaluated B
:
s stem Type(s)
- 0
44i Y o
y
Oth
P
t
Site LTAR
1
ers
resen
: