IPACHTE# o2?~~L 9 Harnett County Department of Public Health
Improvement Permit 2 6 6 3 7
A building permit cannot be issued with only an I~Provement Permit
;J + PROPERTY LOCATION:_
ISSUED ~T,/O•~ ~C a rte. ~J e o ~s Cv,%rl SUBDIVISION LOT #
NEW lQ REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: F ( X 6
Proposed Wastewater System Type: C a -L : 11.1
Projected Daily Flow: .36 G GPD
Number of bedrooms: 3 Number of Occupants: max
Basement ❑Yes QTN,~o
Pump Required: ❑Yes L+~' No ❑ Ma be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community Public ❑ Well Distance from well feet Permit valid for. lZ?"Five years
Permit conditions: ❑ No expiration
Authorized State Agent:: 1 A7,,:-, Ef Date: P o2Gl SEE ATTACHED SITE SKETCH
The issuance of this permit by t ealth Department no way guarantees the issuance 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 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 T0: PROPERTY LOCATION:
SUBDIVISION LOT #
Facility Type: f~ R" R New ❑ Expansion ❑ Repair
Basement? ❑ Yes UKNo Basement Fixtures? ❑ Yes ❑ No
Type of Wastewater System** Con V-A. C -oII-Q- (Initial) Wastewater Flow: GIRD
(See note below, if applicable
Ge>A J~ " ;,._m.k (Repair)
Installation Requirements/Conditions Number of trenches
Septic Tank Size 0GG gallons Exact length of each trench ,S-0 feet
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of. -d inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
Pump Requirements: ft. TDH vs. GPM
Conditions:
Trench Spacing: Feet on Center
Soil Cover: - -7, inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
Aggregate Depth:
inches below pipe
92, inches above pipe
-,12- 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 specified on the application. / accept the specifications 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 per it. SEE ATTACHED SITE SKETCH
C
Authorized State Agent: ~/T-J Date: a2 2--IQd _
Construction Authorization Expiration Date: 2 /
HTE# a-? 3;
9 Permit # c~- 3 7
Harnett County Department of ablic Health
Site Sketch
PROPERTY LOCATON:
ISSUED TO: Cwt f SUBDIVISION LOT #
Authorized State Agent: w a , Date:
t
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: Design Flow (.1949): Property Size:
Location of Site: Property Recorded:
Water Supply: O l ublic❑ Individual ❑ Well
Evaluation Method:1[3"'Auger BOting ❑ Spring
❑ Pit ❑ Cut
Type of Wastewater: Sewage ❑ Industrial Process ❑ Mixed
P
R
O
F
I
1940
SOIL MORPHOLOGY
L
.
Landscape
Horizon
.1941
P'
E
#
Position/
Slope %
Depth
(In.
.1941
Structu
/
1942
.
1941 Soil
Soil
re
Texture
Consistence Wetness/
Mineralo Color
L ✓ J
" 7
v"Sw
G Ir z.
41,1j,111
Description
Site LTAR
❑ Other
OTHER
MFILE FAC
F.1943
Soil
Initial Repair System Other Factors (.1946):
1945) S stem Site Classification (.1948): f
Cc CG Evaluated By: ~M
Others Present:
.1956 .1944 Profile
Sapro Restr Class
Class Horiz & LTAR
l / C
91