IPAC RHTE# -Y-0-o-Qi~~ 2 Harnett County Department of Public Health 2 5 3 6 9
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION:-1 12r
ISSUED TO: H'~-,nv SUBDIVISION (ANO f( fJ1/ r? LOT # _~2?S
NEWS REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: ~!EQ ~ &A r3 - -19yL
Proposed Wastewater System Type:.2 mac( ~L... J
A'_T,
Projected Daily Flow: 3 L GPD
Number of bedrooms: _'2SNumber of Occupants: _Cmax
Basement ❑Yes ',No
Pump Required: ❑Yes ❑ No May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community Pt ❑ Well Distance from well /d ~ feet Permit valid for. 34Five years
Permi
t conditions: 7Cc 0 (l s, th A l Se L7 Af S El No expiration
T14 t3 0 L
ern. W A 1- 2 'Z %a N!22 { C-, 1e--r-
Authorized State Agent:: t-`~ L--.(i-) Date: - -J SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the issuance of other permiu. 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 taws 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: ! Ft-r IJz I 11011e) PROPERTY LOCATION: - 12r
SUBDIVISION Y~ eb ( ,'U LOT
Facility Type: (n7 Y 5 3 New ❑ Expansion ❑ Repair
Basement? ❑ Yes RA~-No Basement Fixtures? ❑ Yes Gallo
Type of Wastewater System" Q j (t A-(, K 4 .,.,S,.t t~ (Initial) Wastewater Flow: 6 -s GPD
(See note below, if applicablc)l)
, ~ lts,1 . (Repair)
Installation Requirements/Conditions Number of trenches 2
Septic Tank Size :030 gallons
Pump Tank Size gallons
Pump Requirements: ft. TDH vs.
Conditions:
Exact length of each trench _ feet
Trenches shall be installed on contour at a
Maximum Trench Depth of. (3 J J inches
(Trench bottoms shall be level to +/-I/4"
in all directions)
GPM
Trench Spacing: '3 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: l underrtand the system type specified is different from the type rpecided on the application. l accept the specifications of this permit.
Owner/Legal Representative Signature: Date:
This Conttrurtion Anthnwi Linn it uihi- t, . r r- - 11-11161,. 111< wuwuuwn nuumncaumt snap not oe transterreo when there 1s 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 nimoal and m tho -diti- „t ,h;, (rr ATTAru[n ctTC curTru
t"-- 4- -1-11LV J11L JILL16rI
Authorized State Agent: Date: T
Construction Authorization Expiration Date: 0 ' t ~ ~ ~ 1
HTE# Permit # 2 5 3
~I
Harnett County Department of lliiblic Health
Site Sketch
(3) PROPERTY LOCATON: k 2
ISSUED TO: SUBDIVISION Lt;c A , n c LOT #
Authorized State Agent: Date:'
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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: C) - rp 3 - Applicant:
Address:
Proposed Facility: Design Flow (.1949):
Location of Site: ' L )
Water Supply: lic Individual Well
Evaluation Method: _;54er Boring [ ] Pit
Type of Wastewater: ~SevVage Industrial Process
Date Evaluated:
Property Size:
Property Recorded:
[ ] Spring
[ ] Cut
[ J Mixed
[ ] Other
P
R
p
F'
SOIL MORPHOLOGY
1941-
OTHER
PROFILE FACTORS
E
.1940
Landscape
Position/
Slope%
Horizon
Depth
IN.)
1941
Structure/
Texture
1941
Consistence
Mineralogy
1942.
Soil
Wetness/'
Color
.1943
Soil
Depth (IN.)
.1956
Sapro''
Class
.1944`
Restr
Horiz
Profile
Class
& LIAR
3
0 Y
G1~1 l_
vFR f
Y ,s
CJk J
0 3,>
Gr• St
3
v
L
A,
C
Description
Initial System
Repair ystem
Available Space (.1945)
System Type(s)
Site LTAR
r
Other Factors (.1946):
Site Classification (.1948):
Evaluated By: lr✓
Others Present: