IPACHTE# Harnett County Department of Public Health 25197
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: `TN6e+J ~An
ISSUED TO: ~Q Qi~_4_\QA:NC N t N(a `a L SUBDIVISION 73 "g.V.u LOT # SO
NEW.' REPAIR ❑ PANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: S P O (S3
Proposed Wastewater System Type: C o tvV~,v«oNP.L~
Projected Daily Flow: 3 LAO GPD
Number of bedrooms: Number of Occupants: max
Basement ❑Yes No
Pump Required: ❑Yes )!~,No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community Public ❑ Well Distance from well 1e0 feet Permit valid for Five years
Permit conditions: ❑ No expiration
Authorized State Agent.: O.S Date: 3 \ ~L- I O5 SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the issu ce of other permits. The permit holderespon
sible 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, .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.
ISSUED T0: ~Q C otv'~2Ac~y NG ~Nc, PROPERTY LOCATION: r sa cE, t~ Rn
SUBDIVISION t r c~tv V"P U_- LOT # 5O
facility Type: ",'i, F9`
~ New ❑ Expansion ❑ Repair
Basement? ❑ Yes 'K No Basement Fixtures? ❑ Yes ` No
Type of Wastewater System" Q o rv v (Initial) Wastewater Flow: 36a GPD
(See note below, if applicable
C-0 rg'J'C_ (Repair)
Installation Requirements/Conditions Number of trenches C.~'
Septic Tank Size t,e,od gallons Exact length of each trench 1S feet Trench Spacing: c1 Feet on Center
Pump Tank Size gallons Trenches shall be installed on contour at a Soil Cover: inches
Maximum Trench Depth of: inches (Maximum soil cover shall not exceed
(Trench bottoms shall be level to +/-1/4" 36" above the trench bottom)
in all directions)
Pump Requirements: ft. TDH vs. GPM
Conditions:
inches below pipe
Aggregate Depth: inches above pipe
inches total
**If applicable: /understand the system type specified /s different from the type specified on the app/ication. / accept the speci6cationr of this permit
Owner/Legal Representative Signature: Date:
This Construction Authorization is subject to revocation; f site pk, plat, or the intended use changes. The Construction Authorization shall not be transferred when there is a change in ownership of the site. Thk
Construction Authorization is s ect compliance with r f laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit. SEE ATTACHED SITE SKETCH
Authorized State Agent: tS Date: 3 a~ 0`1
Constr (on Authorization Expiration Date: 3 2,~-
NTE # O'l Permit # r4-Sl on
Harnett ("onntyT Department of ll~iblic Health
Site sketch
PROPERTY LOCATON: "rv~EN efl
ISSUED TO: ~0 C oN-sLL cgs N SUBDIVISION `TN~E~ PLO C E LOT # 50
Authorized State Agent: n5 ~pLwt`5ot~siXj~ Date:
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Division of Environmental Health
On-site Wastewater Section
SOIL/SITE EVALUATION
for ON-SITE WASTEWATER SYSTEM
Owner:
Address:
Proposed Facility: ~ UI)ft(-= WUS6 Design Flow (.1949): 3~,6
Location of Site: .
- -1.
Property ID:
Lot
File
Code:
Applicant:
Water Supply: Public [ ] Individual ( ) Well
Evaluation Method: Auger Boring [ J Pit
Type of Wastewater: 14,Sewage [ J Industrial Process
Date Evaluated: 3 11~~
Property Size:
Property Recorded:
[ ] Spring [ ] Other
[ ] Cut
[ J Mixed
P
R
o
1=
SOIL MORPHOLOGY
.1941
OTHER
PROFILE FACTORS
1
L
E
#
.1940
Landscape
Posltion/,
Slope%
Horizon
Depth
IN.)
.1941
Structure/.
Texture
'.1941
'Consistence
Mineralogy
1942:
Soil
Wetnessr
Color ;
.1943
Oepth° IN.)
.1955
Saps `
Class
,,1944`
w Re*,,
Horn-
Profile -
Class.
& LIAR -
L
o~
s
v ~tsl
s
G S
vin
Cx
Description
Initia ystem
epair System
Available Space (.1945)
System Type(s)
Gtl N
GO
ISite LTAR
Other Factors (.1946): _
Site Classification (.1948): 5
Evaluated By: t
Others Present:
I S O a'-\ 3 "