IPAC RRHTE# C :Z f Harnett County Department of Public Health 2 4 5 9 3
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
_
PROPERTY LOCATION-.. ,t
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ISSUED TO.,
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o r SUBDIVISION SmpiC „~€6f
LOT #
NEW R(
REPAIR ❑
EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure:
- 0
Proposed Wastewater System Type:
Sr`/e tvc : c =^t
Projected Daily Flow:
3 to t
GPD
Number of bedrooms:
Number of Occupants: G
max
Basement ❑Yes
Ca"'No
_
Pump Required: ❑Yes
❑ No
e required based on final location and elevations of facilities
Ip
Type of Water Supply:
❑ Communi
palic
ty ❑ Well Distance from well feet
Permit valid for. U-five years
Permit conditions:
❑ No expiration
Authorized State Agent: V~ o
Date: sZ 11-7 /2c,07 SEE ATTACHED SITE SKETCH
The issuance of this permit y the Health 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
The construction and installation requirements of Rules .1950, AM,
.
installed in accordance with the attached system layout
ISSUED T0: ~/waocf ~onA~. /~.y lo,+`
Facility Type: _
Basement? ❑ Yes - C No Basement Fixtures?
Retuired for Building Permit
954, .1955, .1956, .1951, .1958. and .1959 are incorporated by references into this permit and shall be met. Systems shall be
PROPERTY LOCATION: q z l
SUBDIVISION d e-c a k LOT #
~ew ❑ Expansion ❑ Repair
❑ Yes ❑ No
Type of Wastewater System*" c2 1&ck 14: - (Initial) Wastewater Flow: J-~ L 0 GPD
(See note below, if applicable
C^ (Repair)
InsWNa = lNuirements/Conditions
Septic Tank Size AX) 0 gallons
Pump Tank Size ICOO gallons
-A nt"_Ject
Pump Requirements: IL TDH vs.
Conditions:
**If applicable:
Exact length of each trench300 - feet
Trenches shall be installed on contour at a
Maximum Trench Depth of. inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
GPM
4 b sc-4- S z l\ r- s ~ c
+ e ~✓ez c,,(J~: 1 d'e~Uert i
Trench Spacing: Feet on Center
Soil Cover inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
inches below pipe
Aggregate Depth: inches above pipe
inches total
l undeatand the system type rpeciled it diherent from the type speciled on the application. l accept the specilcations of this permit.
Owner/Legal Representative Signature: Date:
This Construction Authorization is subject 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 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 Date:--.:7 I ac(;
Construction Authorization Expiration Date: -l/7 -1(1/`/
HTE# Permit # Zqf r3
Harnett ClountyT Department of PW)lic Health
Site Sketch
_ PROPERTY LOCATON: q)
ISSUED T0: SUBDIVISION LOT # a
Authorized State Agent:, Date: ~7 77 2 ec4
r
r
. urITIR✓`
Division of Environmental Health
On-site Wastewater Section
SOIL/SITE EVALUATION
for ON-SITE WASTEWATER SYSTEM
Owner:
Address:
Proposed Facility:
Location of Site:
Water Supply:
Evaluation Method:
Type of Wastewater:
Design Flow (.1949):
r blic [ j Individual
[ Au er Boring
[ Sewage
Property ID: _ E
Lot
File
Code:
Applicant: I f
Date Evaluated:
Property Size:
Property Recorded:
(j Well Spring [ j Other
[ j Pit Cut
[ j Industrial Process [ j Mixed
i
P
R
o
F
.
SOIL MORPHOLOGY
.1941
OTHER
PROFILE FACTORS
L `
E
#
19401
Landscape
Position/
Slope%
Horizon
Depth
(IN.)
1941
Structure/
Texture
1941
Consistence
Mineral
.1942
Soil
Wetness)
Color
'.1943
Sod
Deptiv (IN.)
.1956
Sapra
Class
.1944
f Restr
Horiz
Profiler ,
Class. _
& LTAR
ST f
/r j
-7
Description
Initial Sy
stem
Repair ystem
Available Space (.1945)
/
System Type(s)
02 SU`]~
I Site LTAR
Other Factors (.1946):
Site Classification (.1948):
Evaluated By:,* -
Others Present: