IPACHTE# oAHarnett County Department of Public Health 25176
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: e~s~c~a
ISSUED TO: mom I-AO sl-& u t~UGa~ SUBDIVISION s~~~v G io I LOT #
NEW,( REPAIR ❑ _ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: S ~0 Cho nip
Proposed Wastewater System Type: ou t ~r ,p t
Projected Daily Flow: O GPD
Number of bedrooms: --4, Number of Occupants: max
Basement ❑Yes XI No
Pump Required: ❑Yes ❑ No X May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community Public ❑ Well Distance from well 1(')0 feet
Permit conditions: t
Permit valid for A Five years
❑ No expiration
Authorized State Agent:::.. Date: 18 C) SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the is ce of other permits. The permit holder is res tsible 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: 2`55 ~c~rn E g 01 >_a PROPERTY LOCATION: s~S t ~Ea ~
SUBDIVISION tv G<z LOT #
Facility Type: SK0 S0'- New ❑ Expansion ❑ Repair
Basement? ❑ Yes -;R~ No Basement Fixtures? ❑ Yes )~l No
Type of Wastewater System** C.oN i w~ NO L (Initial) Wastewater Flow: GIRD
(See note below, if applicable
I--g~ (Ronairl
Installation Requirements/Conditions
Septic Tank Size 1 (71, o0 gallons
Pump Tank Size gallons
Pump Requirements: ft. TDH vs.
Conditions:
Number of trenches
Exact length of each trench 11 S
Trenches shall be installed on contour at a
Maximum Trench Depth of: N
(Trench bottoms shall be level to +/-1/4"
in all directions)
GPM
feet Trench Spacing: Feet on Center
Soil Cover inches
inches (Maximum soil cover shall not exceed
36" above the trench bottom)
Aggregate Depth:
inches below pipe
a inches above pipe
_ inches total
**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 Signature: Date:
This Construction Authorization is subject to rev th Ian, 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 subj compliance t sio the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent: \ (2~ Date:
nstruction Authorization Expiration Date:
HTE# O`j ~15w~ Permit # "'SA-J fo
Harnett County Department of Public Health
Site Sketch
PROPERTY LO(ATON: V .12
ISSUED TO: Floss E~ SUBDIVISION ~L~v G«,vE LOT #
Authorized State Agent: GLS 0-n- ~ C Date: 0
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Division of Environmental Health
On-site Wastewater Section
SOIL/SITE EVALUATION
for ON-SITE WASTEWATER SYSTEM
Owner:
Address:
Proposed Facility: ~ G yu~rn tiac~~L Design Flow (.1949):
Location of Site:
W t S
JI tCtfl.
Property ID:
Lot
File
Code:
Applicant:
a er uppiy.Public Individual [ j Well
Evaluation Method: IjAuger Boring (j Pit
Type of Wastewater. I-Lsewage [ j Industrial Process
Date Evaluated: a )
Property Size:
Property Recorded:
[ ] Spring [ ] Other
[ J Cut
[ ] Mixed
P
R
a
F
SOIL MORPHOLOGY
.1941
s OTHER
g.
PROFILE FACTOR
L
E
#
.194U
Landscape
Position/
Slope%
Horizon
Depth
(IN.)
1941
Stru turel~
Texture
4941,
Consistence
Mineralogy
4942
soil
Wetness/
Color
;-"',1043
Soil ;r
De t (Ihl.]
,1956
5a rot'
P
Cla>fs .
,1944`
~ Restr.';-
fiorit-,
r ` +
Profile
&I p- .
L
a
d
4 x
V
Description
Initial System
Repair System
Available Space (.1945)
System Type(s)
) Pp
I Site LTAR
3
1~5
3 _5I'S`'C_t t!9 "
Other Factors (.1946):
Site Classification (.1948): P5
Evaluated By: C)}
Others Present:
3~ C3 a c~ 1-~;"E' ~c>~c ~t(t A ~ x.133 t.. f