IPACHTE# I 1-5-aGi► ' 1 Harnett County Department of Public Health
Improvement Permit 26671
A building permit cannot be issued with only an Improvement Permit
r-~ PROPERTY LOCATION:_ Q ~~ccz~-~ sz t 5 y1p
ISSUED TO: o c s --s 1--~-- C- SUBDIVISION S ~o rvG Gz o 5 LOT # 1 1'
NEWX REPAIR 4 EX SION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: S q- 0 l L'16 M
Proposed Wastewater System Type: a!S '/v 'eZQJC-K,0 04 57SS 64,E
Projected Daily Flow: 3~ ® GPD
Number of bedrooms: 3 Number of Occupants: ro max
Basement ❑Yes No
Pump Required: ❑Yes ❑ No ~ay be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community Public ❑ Well Distance from well ®C'~ feet Permit valid for: Five years
Permit condition3-~ ❑ No expiration
Authorized State Agent:: ~ QK--'i46 Date: -11 201 1) SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the iss a other permits. The permit holders respons le 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 Improve , ermit 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: GTo"r, CR.O55 L --G PROPERTY LOCATION: 0VG-Z 11-L, 5 QD
SUBDIVISION S-c o NC- C. c).0 LOT #
Facility Type: S~9 CL''d~'t SrJ J ~D< New ❑ Expansion ❑ Repair
Basement? ❑ Yes No Basement Fixtures? ❑ Yes XNo
Type of Wastewater System** a5o/. Q-o y GG"C t o Sy.~C-~ (Initial) Wastewater Flow: 360 GPD
(See note below, if applicable
G10 `~-~oy C;-,\ 0 sJ Sy5TE t^ (Repair)
Installation Requirements/Conditions Number of trenches I
Septic Tank Size do COO gallons
Pump Tank Size gallons
Pump Requirements: ft. TDH vs.
Exact length of each trench a~S feet
Trenches shall be installed on contour at a
Maximum Trench Depth of: \-2~- inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
GPM
ns: , `tNs` OCYN b t 0IF Cc;\JZxL. a
Qci p,l
~QR C.-,C
Trench Spacing: C~ Feet on Center
Soil Cover: inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
inches below pipe
Aggregate Depth: inches above pipe
inches total
LsS
WATER LINES (INCLUDING 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: I understand the system type speci(ed is different from the type speciped on the application. /accept the specifications of this permit.
Owner/Legal Representative Signature: Date:
This Construction Authorization is subject to revoc ' if the site pl n, 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 ect to compliance the " ns o Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent: Date: °1 1
Co r ion Authorization Expiration Date: `J 1~
HTE# \ N--S = Z6~31 Permit # `l
r
K
Department of Environment, Health and Natural Resources
Division of Environmental Health
On-Site Wastewater Section
SOIL/SITE EVALUATION
for ON-SITE WASTEWATER SYSTEM
Owner: Applicant:
Address: Date Evaluated:
Proposed Facility: C\rn Design Flow (.1949): ~6d
Location of Site: Property Recorded: J
Water Supply: ublic❑ Individual ❑ Well
Evaluation MethoAuger Bori g ❑ Pit ❑ Cut
Type of Wastewater: 51 Sewage ❑ Industrial Process
Sheet:
Property ID:
Lot
File
Code:
Property Size:
❑ Spring ❑ Other
❑ Mixed
P
R
O
F
1
1940
OIL MORPHOLOGY
.1941
THER
PROFILE FACTORS
L
E
#
Landscape
Position/
Slope %
Horizon
Depth
(hi.)
.1941
Structure/
Texture
.1941
Consistence
Mineralogy
.1942
Soil
Wetness/
Color
.1943
Soil
Depth (IN.)
.1956
Sapro
Class
.1944
Restr
Horiz
Profile
Class
& LTAR
LS 1
_ ~~a
G L.~
30
r
'
-J~ "SL-L-
e s
Description
Initi
S st in
epair System
Other Factors (.1946):
Site Classification (.1948):
Available Space (.1945)
Evaluated By.Z5
System Ty e(s)
` Zs
Others Present:
Site LTAR
G