IPACHTE# !11Harnett County Department of Public Health
Improvement Permit 26 12
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: %
ISSUED TO: R.~ ~a o CL ~t C) C<~ 5 SUBDIVISION '~-r -,Iaa w o bZ, LOT #
NEW"4 REPAIR ❑ ANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: Sec n~S1
Proposed Wastewater System Type: ~ /Q R C-9vGC~ 1) Em
Projected Daily Flow: ' VIQ GPD
Number of bedrooms: Number of Occupants: max
Basement ❑Yes No
Pump Required: ❑Yes '21!~No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community Public ❑ Well Distance from well VD J feet Permit valid for: X Five years
Permit conditions: I ❑ No expiration
Authorized State Agent:: \ \5 Date: 1 SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in n way guarantees the 1 of other permits. The permit holder is res 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 Impro sy,nnt 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, .1957, .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: 1 SL ~\o MEN PROPERTY LOCATION: V\-'~ 'V1
SUBDIVISION 5'S' A2~roy Q LOT # ~a
Facility Type: SgOC'~~r"3~J~~ New ❑ Expansion ❑ Repair
Basement? ❑ Yes No Basement Fixtures? ❑ Yes ~No
Type of Wastewater System** ~1a r~C-.flVGSA0 N 5~15Z 'E,4\ (Initial) Wastewater Flow: d GPD
(See note below, if applicable ?
V C6 ~4.N S`'IS ~ CM (Repair)
Installation Requirements/Conditions Number of trenches 1
Septic Tank Size '\-<3 d O gallons Exact length of each trench '3-LA b feet Trench Spacing: Feet on Center
Pump Tank Size gallons Trenches shall be installed on contour at a Soil Cover: 6 inches
Maximum Trench Depth of: N I 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
Conditions:
Aggregate Depth:
inches below pipe
inches above pipe
inches total
WATER LINES (INCLUDING IRRIGATION) MUST BE ]OFT. 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 specified is different from the type specified on the application. / accept the speciflwions of this permit.
Owner/Legal Representative Signature: Date:
This Construction Authorization is subject to re n if the site plan, plat, or the intended use changes. The Construction Authorization shall not he transferred when there is a change in ownership of the site. This
Construction Authorization is subj compliance wit e ' iq of the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit. SEE ATTACHED SITE SKETCH
Authorized State Agent:
Q&~5 Date: "II1`I tl
on Authorization Expiration Date: 'L ) 6
HTE# N A -5 I IA C~
Permit # '-3-4 -1 ) a
Harnett County Department of Public Health
Site Sketch
PROPERTY LOCATON: Y11-) 'Qn
ISSUED T0: ~»~c-o d cr~ 5 SUBDIVISION `~SPSLwoO~ LOT # 1`i.
Authorized State Agent: - ~LIYE~.'~OLKsDU Date:
IC
Department of Environment, Health and Natural Resources
Division of Environmental Health
On-Site Wastewater Section
SOILISITE EVALUATION
for ON-SITE WASTEWATER SYSTEM
Owner: Applicant:
Address: Date Evaluated:
Proposed Facility: Design Flow (.1949):` `~Fv
Location of Site: Property Recorded:
Water Supply: '9,Public❑ Individual [I Well
Evaluation Method: [ 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
1
L
1940
SOIL MORPHOLOGY
.1941
OTHER
PROFILE FACTORS
E
#
Landscape
Position/
Slope %
Horizon
Depth
(In.)
.1941
Structure/
Texture
.1941
Consistence
Mineralogy
.1942
Soil
Wetness/
Color
.1943
Soil
D th (IN.)
.1956
Sapro
Class
.1944
Restr
Horiz
Profile
Class
& LTAR
a~
o-JI
C:
Description Initial Repair System Other Factors (.1946):
S st
eny' Site Classification (.1948):
Available Space (.1945) Evaluated By: Q
System T e(s) Others Present:
Site LTAR