IPACHTE# J'~- 5~z at ~ Harnett County Department of Public Health 2 5 2 2 8
Improvement Permit
A building permit cannot be issued with only an Improvement Le-rmit
PROPERTY LOCATION: 13,2 f ~5~412J
ISSUED TO: 7D SUBDIVISION LOT #
NEW REPAIR/0 EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance.4, 9 'i A C
Type of Structure: - LtCL X l 7
Proposed Wastewater System Type: 'yc
Projected Daily Flow: ( GPD
Number of bedrooms: 3 Number of Occupants: max
Basement Yes ❑ No
Pump Required: ❑Yes [I No May be required based on final location and elevations of facilities
Type of Water Supply. ❑ Community > PuKc Well Distance from wgll } fel
conditions:
aI-J 1 IIH1011-, 9 r1
TF iQ" h
valid for:
Authorized State Agent:: - I Date: ` rah SEE ATTACHED SITE SKETCH
The issuance of this permit by the Heal 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 TO: PROPERTY LOCATION: S-
SUBDIVISION LOT #
Facility Type: ~e Z A7
New El Expansion ❑ Repair
Basement? 7D~ Yes ❑ No Basement Fixtures? 'Yes JW!W
Type of Wastewater System** C P-gye (Initial) Wastewater Flow: (c GPD
(See note below, if applicable
~J if s--J It (Repair)
Installation Requirements/Conditions Number of trenches
Septic Tank Size 0 _ gallons Exact length of each trench des feet
Pump Tank Size 0, 0 gallons Trenches shall be installed on contour at a
'ZT pvc'-d`«( v Maximum Trench Depth of 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: inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
('Five years
❑ No expiration
, r91 /Y~r w'~'~
inches below pipe
Aggregate Depth: °2 inches above pipe
2 inches total
**If applicable: / anderstaad the system type specified is different from the type specified on the application. /accept the rpecilcationt 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 SEE ATTACHED SITE SKETCH
Authorized State Agent: Date: v' 7
Construction Authorization Expiration Date: 2 1 0 L ° ~
HTE# Permit #
5
Harnett Connty Department of Public Health
Site Sketch
PROPERTY LO(ATON: j
ISSUED TO: SUBDIVISION LOT #
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Authorized State Agent: Date: _L
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Division of Environmental Health
Property ID:
On-site Wastewater Section
Lot
File
SOIL/SITE EVALUATION
Code:
for ON-SITE WASTEWATER SYSTEM
Owner:
Applicant:
Address:
Date Evaluated:
~ C~
Design Flow (.1949):
Proposed Facility: "
Property Size:
Location of Site: ` s.
Property Recorded:
Water Supply: _-KPubiic [ ] Individual
"Lfwell
[ j Spring [ ] Other
Evaluation Method: Auger Boring
[ j Pit
[ ] Cut
Type of Wastewater: Sewage
[ ] Industrial Process
Mixed
P
R
o
F
SOIL MORPHOLOGY
.1941
OTHER
PROFILE FACTORS
{
l
L
E
#
1940
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
f,
Profile
ClaSa
& CTAI2.
1
Gn- j
Vv S
Description
Initial stem
Repair System
Available Space (.1945)
System Type(s)
Site LTAR
Other Factors (.1946):
Site Classification (.1948): V
Evaluated By:
Others Present: