IPACHTE# 0 IS 00-91511 Harnett County Department of Public Health 2 5 2 4 5
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: 2
ISSUED T0: AV, SUBDIVISION t,15 JS h f ft t- LOT # ! 9y
NEW)Z REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: .5f-0" ~ vi - 3
Proposed Wastewater System Type:
Projected Daily flow: 3 O GPD
Number of bedrooms: 3 Number of Occupants: _ o max
Basement ❑Yes I/ No
Pump Required: ❑Yes ❑ No -J2~May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community -7 Public ❑ Well Distance from well t feet Permit valid for. Five years
Permit conditions. I)Ire~ o A A 0I A A 1,4 ( c k ❑ No expiration
UM O c Lil- ~ r hct" S
Authorized State Agent.: - Date: J SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way gu tees 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 intende se 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: C44 neSI PROPERTY LOCATION: e-SUBDIVISION /1 h, t c-- LOT # / S
Facility Type: 1o x 341g- J~;- New ❑ Expansion ❑ Repair
Basement? ❑ Yes ~d No Basement Fixtures? ❑ Yes
Type of Wastewater System** 2~ L c (Initial) Wastewater Flow: '~>L J GIRD i=j i llc~ (See note below, if applicably)
S- Ju /ZedL-.ct'r 3 v (Repair)
Installation Requirements/Conditions Number of trenc es_
Septic Tank Size 0 0 gallons Exact length of each trench_ feet
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of. --Le.-d q 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: C inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
inches below pipe
Aggregate Depth: inches above pipe
inches total
**If applicable: / understand the system type specified is different from the type specifed on the app/ration. / accept the specipcationf of this permit.
Owner/Legal Representative Signature: Date:
This Construction Authorization is subject to revocation if the site plan, plat, or the intended use chanees. The Construction Authorization shall not be tranderrcd whan them f, , A-- h, --hi. M rho it. Thf<
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: 1J Date: _0 2-13 '3, 7
Construction Authorization Expiration Date: `f
HTE# Permit # C~ 5- 04 S
Harnett County Department of lli blic Health
Site Sketch
141
Authorized State Agent:
PROPERTY LOCATON: \ 1;~ ~
SUBDIVISION LVDcd j k LOT #
Date: D2 1-3'3 T
~tn~" k►11 .Sr~Ac ~i
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„~7uD 04
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uepartmunt ul Ci IV❑ Un1 I lCl It, ntrann, auu .vaw a.covu,w + - - - -
Division of Environmental Health Property ID:
On-site Wastewater Section Lot
File
SOILISITE EVALUATION Code:
for ON-SITE WASTEWATER SYSTEM
Owner: .Sr~_ ~p ~S" Applicant:
Address:
Proposed Facility: 5 F~ Design Flow (.1949):
Location of Site: 2
Water Supply: E'~biic (j Individual [ ] Well
Evaluation Method: _Auger Boring [ ] Pit
Type of Wastewater: [ ewage (J Industrial Process
Date Evaluated:
Property Size:
Property Recorded:
( ] Spring
[ ] Cut
[ ] Mixed
[ j Other
P
R
O
F
SOIL MORPHOLOGY
..1941
OTHER
PROFILE FACTORS.
, .
T
L
E
#
1940
Landscape
Position/- .
Slope%
Horizon
Depth
(IN.)
1941
Structure/
Texture
.1941
Consistence
Mineralogy
1942
Soil
Wetness/
Color
.1943
Soil
Depth (IN.)
.1956
Sapror
Class
1944
Restr
Horiz
;
Profile r,
Class
4 4TAR
0
3
1
-2 i
-
N c
I j~
_n
✓
L
Description
Initial System
Repair System
Available Space (.1945)
System Type(s)
Site LTAR
Other Factors (.1946): ~j
Site Classification (.1948): k`
Evaluated By: `
Others Present: