IPACHTE#_ ()j Harnett County Department of Public Health 2 5 3 7 2
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: s g d
ISSUED TO: A- ~nk SUBDIVISION C /3-n , p 1 11- I \ s LOT #
NEW '2( REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: 3S_ - 125 (L
Proposed Wastewater System Type: QVL-V 2 j-1 - . J, SAS.
Projected Daily Flow: '3103 GPD
Number of bedrooms: 3 rY.is,F Number of Occupants: max
Basement ❑Yes Eno
Pump Required: des ❑ No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community JWP lic ❑ Well Distance from well I 0,D fe t Permit valid for `Tive years
Permit conditions: f y} c-I ~ Y\ S i 1 c r w ~Q ~ L. P," ,n a kf ❑ No expiration
Authorized State Agen : 1 Date: 03 a2~-3 `Z SEE ATTACHED SITE SKETCH
The issuance of this permit by 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 i he 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
c
ISSUED TO: PROPERTY LOCATION:, 0~
SUBDIVISION C, 4) n, w 1 f I f f (IT it ,94 A
Facility Type: Sr- I) S7~> X _3~ - 3 0r ❑ Expansion ❑ Repair
Basement? ❑ Yes A~;L_No Basement Fixtures? ❑ Yes ;jio
in all directions)
Pump Requirements: ft. TDH vs. GPM
Type of Wastewater System'* f 2 J-1 c J, (Initial) Wastewater Flow: 3 b Z), GPD
(See note below, if applicable
f 2 f % J ~ (Repair)
Installation Requirements/Conditions Number of trenches C
Septic Tank Size 1000 gallons Exact length of each trench pO~~9 feet Trench Spacing: Feet on Center
Pump Tank Size O gallons Trenches shall be installed on contour at a Soil Cover _ inches
Maximum Trench Depth of: I "K inches (Maximum soil cover shall not exceed
(Trench bottoms shall be level to +/-I/4" 36" above the trench bottom)
Conditions:
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 application. / accept the .rpeci6cationr of this permit.
Owner/Legal Representative Signature: Date:
tms 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 ~pliance 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 Agen 1 o
Date: C) GI
Construction Authorization Expiration Date: - go I
HTE # 9) Id V Permit # ~2,5 3 -7 Z
Harnett (bounty Department of Public Health
Site S ketch
2 ~ PROPERTY LOLATON: I Rd
ISSUED TO: SUBDIVISION C~~nn (/l f -LOT # Authorized State Agent: Date: e) -3
NQd
i~
c~
~p ~ 35c`
~s
7' ~'L_
-y r
t~
A
y
~d
j ,1-t~~~~ COlt~ ~2f
14
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: ` r Design Flow (.1949): Property Size:
Location of Site: 0" na Property Recorded:
Water Supply: Public [ J Individual Well [ J Spring [ J Other
Evaluation Method: jdAuger Boring (J Pit [ ] Cut
Type of Wastewater: [ j Sewage [ J Industrial Process Mixed
P
R
o
F
SOIL MORPHOLOGY
.1941
OTHER
PROFILE FACTORS
1
L
E
#
1940
Landscape
Position/
Slope°!o
Horizon
Depth
(IN.)
1941
Structurel'
.1941
Consistence
Mineralogy
.1942.
Soil
Wetnessh
Color
,
1943.
Soil:
Depth (IN.)
1956
Sapra
Class
1944
Restrr
} Horiz
Profiles
Class
& LTAR
f
jol~
_
Llf
Description
Initial System
Repair System
Available Space (.1945)
_
System Type(s)
ISite LTAR
Other Factors (.1946):
Site Classification (.1948): t
Evaluated By: 9
Others Present: