IP-onlyHTE# I L° ~v- ti91 Harnett County Department of Public Health
Improvement Permit 26491
A building permit cannot be issued with only an Improvement Per it
' PROPERTY LOCATION: M
ISSUED TO: w N N co ty35- - GS t01~1 SUBDIVISION C-3 o,- Uz.5 ~y ca rr~ LOT #
NEWA REPAIR ❑ Ex ANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: ` V o Ls3 d,-1 a' 0fa'N, F-1-0 W)Za, I C) -V E, IF -rA ' C> F. N<-' L~.A
°l~~GOt v m r 1
Proposed Wastewater System Type:
Projected Daily Flow: 3~ o GPD 'S-s or4,5 R
Number of bedrooms: 3 Number of Occupants: max
Basement ❑Yes No r d ~C 7 `"r-0~1 I rd tJ
Pump Required: ❑Yes ',No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community Public ❑ Well Distance from well l0 O feet Permit valid for: Five years
Permit conditions: c ❑ No expiration
Authorized State Agent:: Date: 3 u A 1 SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the issuance her permits. The permit holder is respo sible 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:
Facility Type:
Basement? ❑ Yes ❑ No
Type of Wastewater System** _
(See note below, if applicable
(Repair)
Installation Requirements/Conditions Number of trenches
Septic Tank Size gallons Exact length of each trench feet
Pump Tank Size gallons Trenches shall be installed on contour at a
PROPERTY LOCATION:
SUBDIVISION
❑ New ❑ Expansion C
Basement Fixtures? ❑ Yes ❑ No
Repair
Maximum Trench Depth of: inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
Pump Requirements: ft. TDH vs. GPM
Conditions:
LOT #
(Initial) Wastewater Flow: GPD
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
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 specired is different from the type speciped on the application. / accept the specipcations 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
Construction 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. Jtt AIIALHED MIL SKETLH
Authorized State Agent: Date:
Construction Authorization Expiration Date:
HTE# Permit #
Harnett County Department of Public Health
Site Sketch
PROPERTY LOCATON: Rz
ISSUED T0: ~s ~UGC~O SUBDIVISION CocRt~-2,S Ft-art\ LOT # aZL,
Authorized State Agent: G,as ~0 L--)vZ'- 10 tl~ Date:
'To
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Sam C
Department of Environment, Health and Natural Resources
Division of Environmental Health Sheet:
On-Site Wastewater Section Property ID:
Lot
SOUJSITE EVALUATION File 0:
for 0114-SITE WASTEWATZR SYSTEM Code:
Owner. Applicant:
Address; Date Evaluated:
Proposed Facility: C3C zcb , 099ga Flow (.1949): 7A O Ptopertr Size:
Lmt.iod of site: Propel, Recorded:
Watet Supw. ..Z Public ❑ Individual ❑ Well Evaluadon Method: a Auger Boring ❑ pit cut ❑ spring ❑ Other
Type of Wastewater- -Q-Sewage ❑ Indutdal Process Mixed.
r
it
O
F SOIL MORFHOLOOY
1 .1940 .1941 OTHER
L m Horizon 1941 ?ROMA FACTORa
E Foaitiad Depth .1941 .1941 soil lS49
p Slope % (110 s uchow Coruldem wetneld soil 19re .1944 Frvlii®
Toxhorn Minerdc Color IN. Sapro Rear Claw
Claq Hartz. a LTAR
S
x._18
5P X L . ~ , ,u1 ,
v
utaer Factors (.1946) -
Site Ctatsi8cation (.1948) ?5
Evaluated By: C'ri
Otherspreme 61j\
P5<?;
Q'S
vs
95