IPACHTE#/,/ Harnett County Department of Public Health
hDrovement Permit 2 6 5 3 5
A building permit cannot be issued with only an Improvement Perpit
PROPERTY LOCATIO. Z Lp>
ISSUED T L3 SUBDIVISION LOT # `
NEW REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure:
Proposed Wastewater System Type: Z-5 "Vi-, R ZT X'~0 `~s 1
Projected Daily Flow: '3 bt~ GPD
Number of bedrooms: - Number of Occupants: max
Basement ❑Yes /L+1 No
Pump Required: QYes ❑ No ❑~M,a~'~e required based on final location and elevations of facilities /
Type of Water Supply: ❑ Community Public I-] Well Distance from well feet Permit valid for: 2'Five years
Permit conditions: ❑ No expiration
Authorized State Agen ` ~ /1'Date: SEE ATTACHED SITE SKETCH
The issuance of this permit by Health Department in 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: / 7-4(-- PROPERTY LOCATI 5 - -iti 12 L446
SUBDIVISION LO P#
Facility Type: (5Z /New ~Expansion ❑ Repair
Basement? ❑ Yes No Basement Fixtures? ❑ Yes 12 o
Type of Wastewater System** /qrv l'`- S (Initial) Wastewater flow: GPD - 300 (See note below, if applicable
! '~R ) -7N -
Installation Requirements/Conditions Number of trenches
Septic Tank Size ~ gallons Exact length of each trench feet Trench Spacing: ( Feet on Center
Pump Tank Size z Z~ gallons Trenches shall be installed on contour at a Soil Cover: winches
Maximum Trench Depth of: ~ inches (Maximum soil cover shall not exceed
~t
/ (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
Conditions:
Aggregate Depth:
inches above pipe
Ze 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: /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 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 permit. Jtt AI IALHtV Mit SKETCH
Authorized State ent: Date: /6) - f,:>
Construction Authorization Expiration Date: /6 - to - .14
HTE#i ® Z 71 4 Permit # s"
01
Harnett County Department of Public earth
Site Sketch
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: 15ate Evaluated: /D -7-'~ d/
Proposed Facility: Design Flow (.1949):
Location of Site: Property Recorded:
Water Supply: t_l Public[] Individual ❑ Well
Evaluation Method: Auger Bo ing ❑ Pit ❑ Cut
Type of Wastewater: i7 Sewage ❑ Industrial Process
Sheet:
Property ID:
Lot
File
Code:
Property Size:
❑ Spring
❑ Mixed
❑ Other
P
R
O
F
I
L
1940
L
d
SOIL MORPHOLOGY
.1941
OTHER
PROFILE FACTORS
E
#
an
scape
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
L
Z~ ~t~
Sc~ 7f
30
!X)
b
ra
.
h
.
m
0 _
4c A) 5
Cx-n)5'
f
Description 71nitial Repair System Other Factors (.1946):
Site Classification (.1948):
Available Space .1945) Evaluated By:
System Type(s) Others Present:
Site LTAR