IPACHTE# s -a~a6o Harnett County Department of Public Health
Improvement Permit 2 6 6 9 7
A building permit cannot be issued with only a Improvement Permit
PROPERTY LOCATION: i ~ N GGnf V-0
ISSUED TO: tt;(L KEt,. Lucp,,s SUBDIVISION PVT\ 0 Sa3 of w-; LOT #
NEW~4 REPAIR q ESION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: S @ fl Vs*b -`'3 On''
Proposed Wastewater System Type: a - ) ~J 5 I-ENN
Projected Daily Flow: G PD
Number of bedrooms: 3 Number of Occupants: max
Basement ❑Yes 'C5KNo
Pump Required: ❑Yes 'K No ❑ May be required based on final location and elevations of facilities
Type of Water Sup ly: ❑ Community Public ❑ Well Distance from well feet Permit valid for.
Five years
Permit conditions: ❑ No expiration
Authorized State Agent:: Date: 1 11 SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarani he issuance of other permits. The permit hold r is re onsible 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: SQ,p,Gt 1--V c.AS PROPERTY LOCATI N: 1 r-1GE is R-P
SUBDIVISION jP O)'-zi 5 Qo LOT #
Facility Type: 5~4 "`30J New ❑ Expansion ❑ Repair
Basement? ❑ Yes No Basement Fixtures? ❑ Yes T9 , No Type of Wastewater System** a.~"fo 9-6O V G'c~ \ 0 s-A (Initial) Wastewater Flow: U ® GPD
(See note below, if applicable
Po m 9-1-V 4S-0/0 40 Q PsN t t l (Repair)
Installation Requirements/Conditions Number of trenches d
Septic Tank Size t 000 gallons Exact length of each trench S= feet Trench Spacing: cA Feet on Center
Pump Tank Size gallons Trenches shall be installed on contour at a Soil Cover: ~a N inches
Maximum Trench Depth of. Q inches (Maximum soil cover shall not exceed
(Trench bottoms shall be level to +/-1/4" 36" above the trench bottom)
in all directions)
Pump Requirements: ft. TDH vs. GPM inches below pipe
Aggregate Depth: inches above pipe
Conditions: 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 app/icatiom / accept the specilcations of this permit.
Owner/Legal Representative Signature: Date:
This Construction Authorization is subject t ion 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 skc`to compliarre with,,tlig~rex fiat`s of the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit
SEE ATTACHED SITE SKETCH
Authorized State Agent: kz Date: 1}
Con ruction Authorization Expiration Date: -19 1 116
HTE# 1 1 - 5 a~2,60 Permit #
X33\ I x ~
1
I
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Department of Environment, Health and Natural Resources
Division of Environmental Health
On-Site Wastewater Section
SOIL/SITE EVALUATION
for ON-SITE WASTEWATER SYSTEM
Sheet:
Property ID:
Lot
File
Code:
Owner: Applicant:
Address: Date Evaluated:
Proposed Facility: 1 0S DX07 0~ Design Flow(. 1949): 3(o Property Size:
Location of Site: Property Recorded:
Water Supply: Xj`ublic❑ Individual ❑ Well ❑ Spring ❑ Other
Evaluation Method P~uger Bo 'ng ❑ Pit ❑ Cut
Type of Wastewater: '[31 Sewage ❑ Industrial Process ❑ 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
Depth (IN.)
.1956
Sapro
Class
.1944
Restr
Horiz
Profile
Class
& LTAR
coic)
Description
Initial
S ste
Re System
Other Factors (.1946):
Site Classification (.1948)-
Available Space (.1945)
Evaluated By:
System Ty e(s)
1~
Others Present:
Site LTAR