IPACHTE# 1 15G Harnett County Department of Public Health
Improvement Permit 26674
A building permit cannot be issued with only an Improvement Permit pp
PROPERTY LOCATION: W\i.1... L_oG~ ep
ISSUED T0: jr-1- ~T tea- MG<' SUBDIVISION ~A a Q LOT # ~
NEW'K REPAIR ❑ EXPA SION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: 0 ~3~xu°1
Proposed Wastewater System Type: ~S°~~ F~JUC:, ®fi.S SSE
Projected Daily Flow: "3 h® GPD
Number of bedrooms: 3 Number of Occupants: 6 max
Basement ❑Yes .%<,No
Pump Required: ❑Yes mil, No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community, Public ❑ Well Distance from well M0 feet
Permit conditions:
Permit valid for:
XFive years
❑ No expiration
Authorized State Agent::Date: 0 ~-t i T SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the issua they permits. The permit holder is resp nsible 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 r i 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: Y) t...-t., a~Q-~- A0 t'C-s
Facility Type: S CS-'-3 L-"-a j New
Basement? ❑ Yes -N. No Basement Fixtures? s
PROPERTY LOCATION: ` I I -i- Z- --\j p~5 R.4~'
SUBDIVISION C INCI.OLIr-4N Qp.<5 LOT # '3-1A
❑ Expansion ❑ Repair
XNo
Type of Wastewater System** 7<3-Z:~®/a flU C^N d N '~;Y S-~Z C-- y4N
(See note below, if applicable
a~~ ,-'-..sc~ o u Sy G P(° (Repair)
Installation Requirements/Conditions Number of trenches
Septic Tank Size 4C) Q) Q gallons Exact length of each trench G d feet
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of: al-f -30 inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
Pump Requirements: ft. TDH vs. GPM
Conditions:
(Initial) Wastewater Flow: Q GPD
Trench Spacing: 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
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: / 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 o n if the site pl 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 soike~compliancew-t},the p ns o Caws and Rules for Sewage Treatment and Disposal and to the conditions of this permit. SEE ATTACHED SITE SKETCH
CZL-
~ 5 Date:
Authorized State Agent:
Authorization Expiration Date:
HTE# \l ° S- `-P ) 'S(- Permit # D.(~ 1 H
Harnett County Department of Public Health
Site Sketch
all '
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: 3 aC>C~Jn Design Flow (.1949): 3 64~~ !
Location of Site: Property Recorded:
Water Supply: DPublic❑ Individual ❑ Well
Evaluation Method:fj"Auger Boring ❑ Pit ❑ Cut
Type of Wastewater: Sewage ❑ Industrial Process
Sheet:
Property ID:
Lot
File
Code:
Property Size:
❑ Spring
❑ Mixed
❑ Other
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
Depth (IN.)
.1956
Sapro
Class
.1944
Restr
Horiz
Profile
Class
& LTAR
C?~
Description
Initial
S ste
Repair System
Other Factors (.1946):
Site Classification (.1948):
Available Space (.1945)
Evaluated By:
System Type(s)
~Scf
"1~$ la
Others Present:
Site LTAR
~j