IPAC RHTE#OR-Sou ~?~y Harnett County Department of Public Health
25230
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: \ ~ Z S
ISSUED TO: 00v~tvr- ~ L'or' J SUBDIVISION F3fZCS7 t7C Ics LOT #
NEW-;Z REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: Fd - -3 Gilz - S's- X`4~-(
Proposed Wastewater System Type: S d . c
Projected Daily Flow: lam GPD
Number of bedrooms: ~J Number of Occupants: _-max
Basement ❑Yes No
Pump Required: ❑Yes ❑ No 6May be required based on final location and elevations of facilities
Type of water Supply: ❑ Community Public ❑ Well Distance from well ~Jo fe t Permit valid for. -K Five years
Permit conditions: ' i7o r a I K/
1911 c <~S ❑ No expiration
U o ,n ~•rt cC 1 i c51no r- ly1 cs-c C 1-..~ . .
Authorized State Agent.: W Date: f7)1 SEE ATTACHED SITE SKETCH
The issuance of this permit by th 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 TO: PROPERTY LOCATION:
SUBDIVISION 150 Rci-T 00 h S LOT # 0X
Facility Type: fl)- :NN, Ss-X`F'4 ~ New ❑ Expansion El Repair
Basement? ❑ Yes ~ No Basement ixtures? ❑Yes No
Type of Wastewater System** (Initial) Wastewater Flow:_ GPD
(See note below, if applicable ~ ~
aS
ed,c~ t3,~ S A
(Repair)
Installation Requirements/Conditions
Number of trenches
Septic Tank Size gallons
Exact length of each trench _AQ _ feet
Pump Tank Size gallons
Trenches shall be installed on contour at a
Maximum Trench Depth of: 1$•dq inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
Pump Requirements: ft. TDH vs.
GPM
Conditions:
Trench Spacing: _c Feet on Center
Soil Cover _ I inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
Aggregate Depth:
inches below pipe
inches above pipe
inches total
**If applicable: /under fond the system type pacified is different from the type specified on the app/ication. / accept the specificmionr of this permit
Owner/Legal Representative Signature: Date:
••.u,, 14 . ,,t==, Alt Na., P1Qti U1 tilt ❑nenueu use alanges. ine construcnon Authorization snau not he transterred 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
1 :2 ~
Authorized State Agent: Date: ~cJ
Construction Authorization Expiration Date: /
qq ~o - t3c~'4 p
HTE# O - Permit # :9 5 Q 3D
nar•nett County Department of hiblic nealth
Site Sketch
PROPERTY LOCATON: C ~ a
ISSUED TO: ll.• SUBDIVISION _ f3Rr-St C) P, LOT #
Authorized State Agent:- Date:
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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: ~J Applicant:
Address:
Proposed Facility: s rj? Design Flow (.1949):
Location of Site: 12
Water Supply: A Public [ j Individual [ ] Well
Evaluation Method: Auger Boring [ ] Pit
Type of Wastewater: [lJ Sewage [ ] Industrial Process
Date Evaluated:
Property Size:
Property Recorded:
[ J Spring
( J Cut
[ ] Mixed
( I Other
P
0
F
SOIL MORPHOLOGY
1941
OTHER
PROFILE FACTORS
J 'S Y
1
L
E
#
1940
Landscape
PositiorU
Slope%
Horizon
Depth
(IN.)
1941
Structure/
Texture
1941
Consistence
Mineralogy
.1942
Soil
Wetness/
Color
.1943
Soil
Depth (IN.)
.1956
Sapra
Class
1944`
Restr
Horiz
Profile' '
Class,
& LTAR
C7 j
V f
Y
Description
Initial System
Repair System
Available Space (.1945)
System Type(s)
Site LTAR
Other Factors (.1946):
Site Classification (.1948): 1
Evaluated By: , r
Others Present: