IPACHTE# o 7-s= p V7y7 Harnett County Department of Public Health 2 5 2 5 2
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
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PROPERTY LOCAT N: I
covet
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7
ISSUED TO:
NEW
R"y
SUBDIVISION v^• Q o; 1
LOT # /7
REPAIR ❑
J
-
EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure:
1 !
_,_5
Proposed Wastewater System Type:
Ju eau ;cw.fl,
Projected Daily Flow.
3G0
GPD
Number of bedrooms:
3
Number of Occupants: max
Basement ❑Yes
P"No
Pump Required: ❑Yes
k "No
❑May
,be required based on final location and elevations of facilities
Type of Water Supply:
❑ Community
L~~' Public ❑ Well Distance from well feet Permit valid for.
I9"Five years
Permit conditions:
❑ No expiration
Authorized State Agent.: 1~~ Date: Ztir'~l SEE ATTACHED SITE SKETCH
The issuance of this permit by eafth 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 Qermit 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, .19
52, .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:
5~
"/clerr
J"
PROPERTY LOCH ON:
Sl-
Facility Type:
SUBDIVISION
(New ❑ Expansion ❑ Repair
c; -4 LOT #
Basement? ❑ Yes ER/No
Baseme t Fixtures?
Yes ❑ t)o
j
Type of Wastewater System
o
'
e
c
(Initial) Wastewater Flow:'5~0 GPD
(See note below, if applicable
.25-/o
I-ed.c/
~.e.... (Repair)
Installation Requirements/Conditions
Number of trenches J
Septic Tank Size / OW
gallons
Exact length of each trench S~ feet
Trench Spacing: Feet on Center
Pump Tank Size
gallons
Trenches shall be installed on contour at a
Soil Cover: inches
Maximum Trench Depth of: OY--70 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
inches below pipe
Conditions:. n-~
Aggregate Depth: inches above pipe
inches total
**If applicable: /understand the system type specified is different from the type specified on the app/ication. / accept the specipcationr 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 ownershin of thn vrr Thic
Construction Authorization is subject to compliance with the
Authorized State
of the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Date:
Construction Authorization Expiration Date: `120-1c/
HTE#~-S = l 7~~
Permit # 25-4~-k
Harnett County DepaAnlent of Public Health
Site Sketch.
PROPERTY LOLATON:
ISSUED T0: 'C ~c~: ~r~ tr-j .-~•1C~ SUBDIVISION LOT # J 7
Authorized State Agent: Date: 5~/ .712
1 ck
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ueparttnent ul CIIviwitmw it, nCdim, dllu IVdtutdl mt-buuAt:CJ
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):
(Public Individual
[A er Boring
( rSeage
JI ICCI.
Property ID:
Lot
File
Code:
Applicant:
Well
[ ] Pit
Industrial Process
Date Evaluated:J(3 r~
Property Size:
Property Recorded:
[ J Spring [ J Other
Cut
[ J Mixed
P
R
o
F
SOIL MORPHOLOGY
-.1941
OTHER
PROFILE FACTORS
; .
1
L
E'
#
.1940
Landscape
Position
Slopee%
Horizon
Depth,
(IN.)
1941
Structure/
Texture
.1941
Consistence
Mineralogy
.1942.
Soil
11
Wetness/ -
Color
1_
1943
Soil
Depth (IN.)
.1956
Sapra
Class
1944
Restr•
Horiz
Profile~
Class,
& LTAR
-y F
G I ~
v.~rrrr
Description
Initial System
Repai System
Available Space (.1945)
System Type(s)
Site LTAR
'
Other Factors (.1946):
Site Classification (.1948):
Evaluated By: Jf"-
Others Present: