IPACHTE# Oq -s-00-dl 63 z Harnett County Department of Public Health 2 5 3 5 9
Imurovement Permit
A building permit cannot be issued with only an Improvement Permit
j`~ PROPERTY LOCATION: I~
ISSUED TO: en 111t4k 1 U (Y1M t 1,V 5 SUBDIVISION tJ ~~TS z ~t c LOT # ~
NEW REPAIR ❑ EXPANSIO ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: C0 - 9 77f In Q - Q 2
Proposed Wastewater System J Tip!: ~Ss A'J -'~i
Projected Daily Flow: _'J GPD
Number of bedrooms: "3 Number of Occupants: max
Basement ❑Yes J4 No
Pump Required: ❑Yes ❑ No
Type of Water Suppl : ❑ Commt
Permit conditions: X4 f
Permit valid for. 'Five years
rk-1 ❑ No expiration
Authorized State Agent.: L- q Date: 03 --03 % SEE ATTACHED SITE SKETCH
The issuance of this permit by the Ith 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, .I9S6, .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 T0:~e/Ic~ ~t c~~► ~wp PROPERTY LOCATION: //2 J~
SUBDIVISION l4~~ 1~, rz LOT # 16 V
Facility Type: )?Y - 30" AE9 New ❑ Expansion ❑ Repair
Basement? ❑ Yes K No Basement Fixtures? ❑ Yes No
Type of Wastewater System** X) ~1 V" Ct C r n-. (Initial) Wastewater Flow: _3 GPD
(See note below, if applicable
/)u 7`- 2}"l V~~~~R S S. (Repair)
Installation Requirements/Conditions Number of trenches
Septic Tank Size gallons Exact length of each trench c~~f0 feet
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of 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: inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
Aggregate Depth:
inches below pipe
inches above pipe
inches total
**If applicable: / understand the system type specified is different from the type specified on the app/icmion. / accept the specifications of thin permit.
Owner/Legal Representative Signature: Date:
urn wmouwuo Humonzanon is suolect to revocation it the site plan, plat, or the intended use changes. Me Lonstruction Authorization shall not be transferred 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
May be required based on final location and elevations of facilities
y ,->4- Pdlic ❑ Well Distance from well /0-:> feet
Authorized State Agent: Date:
Construction Authorization Expiration Date: 613 J3 _dol
HTE# 09-5-00- 31(o3 L Permit # xk~_-3-_~
Harnett County Department of ll~iblic Health
Site sketch
PROPERTY LOCATON: 112 )
ISSUED TO: /c n c r SUBDIVISION lnDj, S h rt LOT # ~
Authorized State Agent Azcj Date: 03--D3
i
10
)e to f a A' e L_ t nc S I"L-3,
1g, `
Division of Environmental Health Property ID:
On-site Wastewater Section Lot
File
SOIL/SITE EVALUATION Code:
for ON-SITE WASTEWATER SYSTEM
Owner: 1-~ o"2 J (e JZ Applicant:
Address: Date Evaluated:
Proposed Facility: p-Design Flow (.1949):
Property Size:
Location of Site: 2 Property Recorded:
Water Supply: blic Individual [ j Well
[ ] Spring [ ] Other
Evaluation Method: ger Boring [ ] Pit [ ] Cut
Type of Wastewater: Sewage Industrial Process [ ] Mixed
P
R
o
F
SOIL MORPHOLOGY .
.1941
OTHER
PROFILE FACTORS-
1'
L
E
#
.1940
Landscape
PositioN
Slope%
Horizon
Depth
IN.)
1941=
Structurel
Texture
1941
Consistence
Minera
.1942
, Soil
Wetness/
Color ,
.°~1943~_;
s :1 Soil
Depth (IN.)
,1956
Saprat
Class
194,r-
Restr".
Horiz ,
PPoflle
Class • : {
& LTAR
~~Y
G~St
U~~
31,
I~3
op JCL
rF--
`f
0
tis L
[ J
v6-
lZ Ja'
y J,
~~~r
~h ~ lr
r=te
Description
Initial System
Repair System
Available Space (.1945)
System Type(s)
v
Site LTAR
I
A4
Other Factors (.1946):
Site Classification (.1948): r
Evaluated By: 9'Ci
Others Present:
f
v