IPACHTE# 09- Harnett County Department of Public Health 2 5 2 5 1
Im rovement Permit
A building permit cannot be issued with only an Improvement Permit
p PROPERTY LOCATION . C✓'a
ISSUED TO: J~..tic J>v. err ~~c SUBDIVISION .4
~L LOT #
NEW REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: 4D G v 4 q0'
Proposed Wastewater System Type: rr7. cc v
Projected Daily Flow: to V GPD
Number of bedrooms: J Number of Occupants: max
Basement ❑Yes Llo-
Pump Required: ❑Yes E?/No ❑M.,a/y be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community 5 Public ❑ Well Distance from well feet Permit valid for. lt'five years
Permit conditions:
❑ No expiration
Authorized State Agenc:
- Date: a2~ e 9 SEE ATTACHED SITE SKETCH
The issuance of this permit by 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
(Required for Building Permit)
The construction and installation requirements of Rules .1950, .1952, .1954, .1955, J956, AM, .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: C ~t::.ly~erf ~~c PROPERTY LOCATION:
SUBDIVISION -,r LOT #
Facility Type: cjrICD TrNew ❑ Expansion ❑ Repair
Basement? ❑ Yes li/No Basement Fixtures? ❑ Y ❑ No
Type of Wastewater System** d ,%ZeA" ~ 1 !J ~jj/c (Initial) Wastewater Flow: JL 0 GPD
(See note below, if applicable
5- {.A, 4-t- s-fc,-(Repair)
Installation Requirements/Conditions Number of trenches 3
Septic Tank Size COO gallons Exact length of each trench S"U feet
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of. 5,',30 inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
Pump Requirements: ft. TDH vs. GPM
Trench Spacing: 9 Feet on Center
Soil Cover. G-/8 inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
inches below pipe
Aggregate Depth: inches above pipe
Conditions: all -J-t+ 6k, ck-
inches total
**If applicable: / ande,,rtand the ryrtem type .rpeci6ed it different from the type rpeci6ed on the application. /accept the rpeci6cationa of this permit.
Owner/Legal Representative Signature: Date:
This Construction Authorization is subject to revocation if 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: `//J ,2aa9
Construction Authorization Expiration Date: y -0
2~~~
HTE# 0~-
Permit #
narnett cOnnty Department of Public nealth
Site Sketch
PROPERTY LOCATON: SW
ISSUED TO: ( 'pT ySUBDIVISION LOT #
Authorized State Agent: / ~ z
1 S`~e
ueparurlanlol GIVIIUIIIIIeIII, nt:d1m, dllu IVdlUldl rIeDUUIGCJ Jl leel.
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: 11 IOl-
Proposed Facility: Design Flow (.1949): Property Size:
Location of Site: Property Recorded:
Water Supply: CPublic Individual [ ] Well [ ] Spring [ j Other
Evaluation Method: [ ~ Aq9er Boring [ ] Pit [ ] Cut
Type of Wastewater: [ J~Sewage [ j Industrial Process (j Mixed
P
R
o
F
"
SOIL MORPHOLOGY :
.1941
OTHER
PROFILE FACTORS
i
4
E.
#
1940
Landscape
Position/.
Slope%
Horizon
Depth
(IN.)
1941
Structure/
Texture
1941
Consistence
Mineralogy `
.1942
Soil -
Wetness/'
Color
.;.1943
Soil _
Depth (IN.)
.1956
Saprd'
Class
1944
Restr
Horiz
Profile
Class
& L,TAR
Cf
G
Description
Initial System
Repair System
Available Space (.1945)
System Type(s)
Site LTAR
Other Factors (.1946):
Site Classification (.1948)
Evaluated By: ti
Others Present: