IPACHTE#a0 -5 1'-L- l Harnett County Department of Public Health 2 51 8 3
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: c~~ ~z C~ tic k
ISSUED TO:ao~~o~om S SUBDIVISION " uoso,a 1 eP < LOT #
NEW REPAIR ❑ ~fXPANSI ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: LA
Proposed Wastewater System Type: C~r< v E~ a s r
Projected Daily Flow: 2 GPD
Number of bedrooms: Number of Occupants: max
Basement ❑Yes 'k No
Pump Required: ❑Yes XNo ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community Public ❑ Well Distance from well t (~)O feet Permit valid for. Five years
Permit conditions: ❑ No expiration
Authorized State Agent: Date: 3 )1`41 0'1 SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees then c 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 Improve nt 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: Q-A-A'30 VN a c~Cs
Facility Type: ~1a~~ S~✓ New
Basement? ❑ Yes "12, No Basement Fixtures? ❑ Yes
Type of Wastewater System** C-0
(See note below, if applicable
PROPERTY LOCATION: L-C,,\vc- Q)
SUBDIVISION u y c)nor A )i sz p c, LOT # J
❑ Expansion ❑ Repair
'ig No
(Initial) Wastewater Flow: 3 C) GPD
C-0 V b cs L-- (Repair)
Installation Requirements/Conditions Number of trenches
Septic Tank Size t b e O gallons Exact length of each trench
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of: '-4
(Trench bottoms shall be level to +1-114"
in all directions)
Pump Requirements: ft. TDH vs. GPM
Conditions:
feet Trench Spacing: Feet on Center
Soil Cover S inches
inches (Maximum soil cover shall not exceed
36" above the trench bottom)
Aggregate Depth:
inches below pipe
inches above pipe
1 inches total
**If applicable: / understand the ryrtem type speciled it different from the type Jpeciled on the application. / accept the rpeci6cmionr o/ this permit
Owner/Legal Representative Signature: Date:
mu wnsrumon Rutnonzauon is suDlect to revocation it 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 w th ' sio~s. the laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent: L~ Date: 14'70
14
Conte ion Authorization Expiration Date: 3
HTE# 0 71 ~"-l Permit # ~5V63
Harnett County I)epartmnent of 11~ blic Health
Site Sketch
PROPERTY LOCATON: LC~vCL P>> ~C
ISSUED TO- SUBDIVISION
Authorized State Agent: -TO Ly-~LSi4 Date: 3 d°I
('00,
Division of Environmental Health
On-site Wastewater Section
SOIL/SITE EVALUATION
for ON-SITE WASTEWATER SYSTEM
Owner:
Address:
Proposed Facility: 3 axt~ Design Flow (.1949): 360
Location of Site:
t
Property ID:
Lot
File
Code:
Applicant:
Water Supply: X Public Individual [ J Well
Evaluation Method: "Auger Boring [ J Pit
Type of Wastewater: Sewage Industrial Process
Date Evaluated: 314Oq
Property Size:
Property Recorded:
[ J Spring [ ] Other
( ] Cut
[ ] Mixed
P
R
o
F
SOIL MORPHOLOGY
.1941 `
OTHER
PROFILE FACTORS
1
L
E
#
.1940
Landscape
Position!
Slope%
Horizon
Depth
(IN.)
1941
Structure/
Texture
1941 '
Consistence
Mineral
.1942. ,
Soil
Wetnessf
Color
1943
Soil
Depth (IN.)
1956
Sapror
Class
1944
j Restr
Horiz
Profile
Class
& LTAR
~
0 -4 ei
C 5
Vet ~5 ~ %rQ
S
LAO
M
-
0_4
-S
1?1
c--LIO
(:,-5
v ~EQ_ + 3 Q
S
Description
Initial ystem
pair System
Available Space (.1945)
System Type(s)
G~
~~,j
Site LTAR
,g
Other Factors (.1946):
Site Classification (.1948): 5
Evaluated By: O
Others Present:
3xS c~ ~1't,