IPACHTE# 0`N J'
0- 3 1 5 Harnett County
Department of Public Health 2 5 3 5 5
Imp
rovement Permit
A building permit cannot be issued with only an Improvement Permit
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PROPERTY LOCATION- I ka~^
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ISSUED TO:
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SUBDIVISION
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St Q A L LOT #
NEW
REPAIR ❑
EXPANS
❑
_
.
Type of Structure:
-
ION
q- x S 8 - Q,~
Site Improvements required prior to Construction Authorization Issuance:
Proposed Wastewater System Type:
S't~
Projected Daily Flow:
7~) u3 GPD
Number of bedrooms:
3
Number of Occupants: ~a
max
Basement ❑Yes
IXNo
Pump Required: ❑Yes
❑ No
` S ' May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community ILPublic ❑ Well Distance from well 4-0s..) feet Permit valid for 91 Five years
Permit coo~nditiconns:'ymc'-4 015 , '3~- F,,. .A~o fw,, n Ce±~Fl~ZC_S El No expiration
5hNIN C, (~FVnnc ryc o,- h t-,z cc- / lher-c -'6'3 tl~
Authorized State Agent:: c- / Date: Oa `c--) (o ~ 5 SEE ATTACHED SITE SKETCH
The issuance of this permit by th ealth 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, 1957, .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: ~/f I'~21) I •c~ PROPERTY LOCATION: Z
SUBDIVISION ~ i` J `l CAA C LOT #
Facility Type: SrQ` ~g - 3~ r` New El Expansion ❑ Repair
Basement? ❑ Yes 0l No Basem nt Fixt resl ❑ Yes = No
Type of Wastewater System * Lc t (Initial) Wastewater Flow: _3 6 GPD
(See note below, if applicable
(~PcL J(,... (Repair)
Installation Requirements/Conditions Number of trenches If
q
Septic Tank Size 1000.3 gallons Exact length of each trench feet Trench Spacing: f Feet on Center
Pump Tank Size gallons Trenches shall be installed on contour at a Soil (over: inches
Maximum Trench Depth of. ~8 o) 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
*"If applicable: / underrtand the .ryrtem type .rpe~ified i1 di/lerent from the type rpeciled on the app/ication. /accept the jpeci~cationr of thin permit
Owner/Legal Representative Signature: Date:
-1.1- - -J111 lU -VLduuu a me vre pian, plat, or me mrenaea use changes. me construction Admonzanon shall not be transferred when there is a change in ownership of the site. This
Construction Authorization is subject to c ce with the provisions of the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit e, SEE ATTACHED SITE SKETCH
Authorized State Agent: Date:
Construction Authorization Expiration Date:
HTE#
Permit #J 3
Harnett County Depailment of '~iblic Health
Site Sketch
PROPERTY LOCATON: I Ia
ISSUED T0: SUBDIVISION J7 oo ~s LOT # _
Authorized State Agent: ~ ✓ Date: A
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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:
Proposed Facility: Design Flow (.1949): L J Property Size:
Location of Site: [ 2 Property Recorded:
Water Supply: 7 _ ublic Individual (j Well Spring [ j Other
Evaluation Method: O~tuger Boring [ j Pit [ J Cut
Type of Wastewater. ~4ewage [ I Industrial Process [ j Mixed
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SOIL MORPHOLOGY `
.1941
OTHER
PROFILE FACTORS
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#
A940
Landscape
PositioN .
Slope'
Horizon
Depth
IN.)'
1941.
Structure!
Texture
.1941
Consistence
Mineralogy
1942
Sort
Wetness/
Color
s; 1,1943.
F Soo:;-
Depth lN.}
r
=.1956
SaPta
Class
f 1W
Rests: ,
= f grit ,
Profile
Class ,
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Description
Initial System
Repair System
Available Space (.1945)
System Type(s)
25-1-
6_-, r,a Q~ y
Site LTAR
~ ~
,
Other Factors (.1946):
Site Classification (.1948):
Evaluated By:
Others Present: