IPACHTE# 01- s'- rl Harnett County Department of Public Health 2 5 2 5 6
Improvement Permit
A building permit cannot be issued with only an Improvement Pe it
pp PROPERTY LOCATI N: ~
ISSUED TO: ~ I Duo 14k--✓ SUBDIVISION G; z LOT #
NEW IR' REPAIR ❑ , f EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: A..~iFd G K
Proposed Wastewater System Type: X,
Projected Daily Flow: GPD
Number of bedrooms: _ Number of Occupants: L max
Basement ❑Yes [A-0
Pump Required: ❑Yes Ei- ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community K" Public ❑ Well Distance from well feet Permit valid for >ve years
Permit conditions: ❑ No expiration
Authorized State Agent: Z _ J , Date: SEE ATTACHED SITE SKETCH
The issuance of this permit by Ce 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, .19
52, .1954, .1955, .1956, .1951, .1958. and .1959 are incorporated by references in
to this permit and shall be met. Systems shall be installed in accordance
with the attached system layout
ISSUED TO: ~~c: ~
Pv<~a
PROPERTY LOCAT N: -S
-4-
.c.~
G
Facility Type:
,
SUBDIVISION ,Ir
ET--New ❑ Expansion ❑ Repair
LOT # 6a
Basement? ❑ Yes No
*
Basement Ft tur s? Yes ❑ No
~
Type of Wastewater System
~
(Initial) Wastewater Flow: J
6 6 GPD
(See note below, if applicable
dX
-C.1'1 (Repair)
Installation Requirements/Conditions
Number of trenches
Septic Tank Size 000
gallons
Exact length of each trench f S'_0 feet
Trench Spacing: feet on Center
Pump Tank Size
gallons
Trenches shall be installed on contour at a
Soil Cover: 12 - inches
Maximum Trench Depth of: J` G 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
C
di
i
L
-
Aggregate Depth: inches above pipe
on
t
ons:
l
inches total
`"If applicable: / mnderrtand the system type specified is different from the type specified on the app/ication. / accept the specifcatiox of this permit.
Owner/Legal Representative Signature: Date:
This construction Authorization is subject to revocation if thr cite nlan Mar nr tho intondod n<o rh-- Th. A-h-d„6,.,..h<n k ....r....a .,,w. . _ _.____c- ,.........b. Y
lonstrucuon 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
G
Authorized State Agent: Date: V
Construction Authorization Expiration Date: 1 fr
HTE# y~ ^ S' c, l °7 s"/ Permit # d, S~ot•f` C
Harnett (county Department of Public Health
Site Sketch
PROPERTY LO(ATON: S~
ISSUED TO: ~c • . ~~~r SUBDIVISION LOT # IF0
c
Authorized State Agent: c _ Date: `~/oCG
I
OQ
s
t
ry r
~q
Y`E
4d V
1pv•
/rc `
ueparunenI of Clivnunment, rlCdlu I, .111U 1odtul do
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):
[,I Public (J Individual
['Auger Boring
[,,fSewage
oI1CCt.
Property ID:
Lot
File
Code:
Applicant:
Date Evaluated: /-7t Property Size:
Property Recorded:
[ ] Well (j Spring (j Other
[ ] Pit [ j Cut
[ J Industrial Process [ J Mixed
P
R
o
F
SOIL MORPHOLOGY
1941`.
OTHER
PROFILE FACTORS
1
L
E
#
.1940
Landscape
Positiont
Slope%
Horizon
Depth
(IN.)
1941
Structure/
Texture
A941
Consistence
Mineralogy
.1942.
Soil
Wetness/'.'
Color
_ -..1943
Soil' ;
Depth (IN.)
.1956
Sapro
Class
A944
Restr'
Horiz
Profile L
Class.
& LTAR
f
l~
lY
G
vk-
Description
Initial Sy
stem
Repair System
Available Space (.1945)
/
System Type(s)
Site LTAR
Other Factors (.1946):
Site Classification (.1948):
Evaluated By:
Others Present: