IPACHTE# ►3: S-) t~c Harnett County Department of Public Health
Improvement Permit 2 7 0 5 7
A building permit cannot be issued with only an Improvement Petit
PROPERTY LOCATION: M
ISSUED TO: C vm(~,Esxzr~,nct> ~AomcC-a, SUBDIVISION P's -,ST,-t(1P LOT # Zll~
NEWX REPAIR ❑ E NSION El
Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: S 4F" '~Ll I
Proposed Wastewater System Type: a51/6 REOt1GK~W4 SySiG"`
Projected Daily Flow: 3 rod GPD
Number of bedrooms: 3 Number of Occupants: max
Basement ❑Yes No
Pump Required: ❑Yes No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community X Public ❑ Well Distance from well LZ)0 feet Permit valid for: Five years
Permit conditions: _ ❑ No expiration
Authorized State Agent:: Date: 5 ~ 31 ` Y1... SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the issuance o ermits. The permit holder is r sponsible 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 Peri all 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: Cvms3E4~Q,~c9 ~AomPROPERTY LOCATION: 1 INt*" ~D
SUBDIVISION NLD LOT # QQS
Facility Type: X New ❑ Expansion ❑ Repair T
Basement? ❑ Yes LXNo Basement Fixtures? ❑ Yes No
Type of Wastewater System** a5Vo RGOvG-s, PJ 'W SyS ~ C-- H\ (Initial) Wastewater Flow: -YO GPD
(See note below, if applicable
2-$°l0 1 G.Q-V y tv Sys S G-r~ (Repair)
Installation Requirements/Conditions Number of trenches )
Septic Tank Size 1d 04 gallons Exact length of each trench NJ0 feet Trench Spacing: Feet on Center
Pump Tank Size gallons Trenches shall be installed on contour at a Soil Cover: inches
Maximum Trench Depth of: 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 IOFT. FROM ANY PART OF SEPTIC SYSTEM OR REPAIR AREA.
NO UTILITIES ALLOWED IN INITIAL OR REPAIR DRAIN FIELD AREA.
**If applicable: l understand the system type specified is different from the type specified on the application. l accept the specifications of this permit.
Owner/Legal Representative Sig Date:
This Construction Authorization is subject to revocation if Zllat, 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 suI>ct`NTpliance 4ons o s and Rules for Sewage Treatment and Disposal and to the conditions of this permit. SEE ATTACHED SITE SKETCH
Authorized State Agent:F Date: 51-6)1)
Construc ' Authorization Expiration Date:
HTE# Permit # Q--)0S
Harnett County De artinent of -M-tblic Health
Site Sketch
PROPERTY LOCATON: SY1 ,
ISSUED TO: C-~ i3 ~vS~ ~~oc`n SUBDIVISION 0q, LOT # c~•2,.
Authorized State Agent:
I)F- Date:
2Zj7~
Lor-X~wOaq O(L
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 c) Q' Design Flow (.1949);3(Q
Location of Site: Property Recorded:
Water Supply: ublicE] Individual ❑ Well
Evaluation Method:Aug Boring ❑ pit Cut
Type of Wastewater: ~ Sewage ❑ Industrial Process
Sheet:
Property ID:
Lot
File
Code:
Property Size:
❑ Spring
❑ Other
❑ Mixed