IPACHTE# 0~- = 2, IFrO Harnett County Department of Public Health 25261
Improvement Permit
A building permit cannot be issued with only an Improvement Perm
PROPERTY LOCATI N: Sy- It 3 ~j ! f e.ti led.
ISSUED TO: C/~k 4,/---r SUBDIVISION ~c t~~:r o; tE LOT # 13
NEW REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: 37 GP 7
Proposed Wastewater System Type:
Projected Daily Flow: 26-0 GPD
Number of bedrooms: ,7 Number of Occupants: max
Basement ❑Yes M N
~Pump Required: ❑Yes No ❑R" Mae required based on final location and elevations of facilities
Type of Water Supply: ❑ Community Public ❑ Well Distance from well feet Permit valid for [?-rive years
Permit conditions: ❑ No expiration
Authorized State Agent:: . /-A-- wo., ~C <J, Date: V& 4~1~cfct 9 SEE ATTACHED SITE SKETCH
The issuance of this permit by th ealth Department in no no 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 taws 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 ASO, .1952, .1954, ASS, .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 TO: 9;// k MC/ PROPERTY LOCAT ON: rX 11-79
11.1 SUBDIVISION J-I( r
e LOT #
Facility Type: FD New ❑ Expansion ❑ Repair
Basement? ❑ Yes No Basement Fixtures? Yes ❑ No
Type of Wastewater System** - -u, - a%_ vc,.. 14 c~
(Initial) Wastewater Flow: GPD
(See note below, if applicable
y
OZf 4 .ec l u f~ ti (Repair)
Installation Requirements/Conditions Number of trenches
Septic Tank Size ,500 gallons Exact length of each trench (00 feet
Trench Spacing: y Feet on Center
Pump Tank Size gallons Trenches shall be installed on contour at a
Soil Cover % 2- inches
Maximum Trench Depth of: a y 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: h. TDH vs. GPM
inches below pipe
.1
Ccw~~~ r-
.cy ~
Conditions: t~✓~
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 rpecificationr of thif permit
Owner/Legal Representative Signature: Date:
u 11-1 - -.1-1 1. 111 L-1 n me Ine pian, pias, or me mtenaea use cnanges. lne 6onstrucuon 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
C
Authorized State Agent: >a+ _ . Date: f ' O°~
Construction Authorization Expiration Date: / i '-/Y,
HTE# O -J-- d, 1ff e Permit it 6- ~7 I
Harnett Connty Department of ll~iblic Health
Site Sketch
PROPERTY LOCATON: ,Pd.
ISSUED T0: _ ~~~~C~c~.-~= ~oa~V SUBDIVISION c~•~~ ~E LOT #
Authorized State Agent: Date: V//
3i
FV
1 Y,4'
uepartmum UI mimiu11 miilt, rVd1U1, dllu IVd !111t:JUUlt.tlZ,
Division of Environmental Health
On-site Wastewater Section
SOILSITE EVALUATION
for ON-SITE WASTEWATER SYSTEM
Owner:
Address:
Proposed Facility: Design Flow (.1949):
Location of Site: 1
Water Supply: I Lky Ublk Individual
Evaluation Method: (uger Boring
Type of Wastewater J Sewage
R
o
F
1
L
E
0
SOIL MORPHOLOGY
.1941
.1940
Landscape Hortaon .1941 .1941
PosftW Depth Structure/ Consblenm
S % -(IN.) I Textuas
t-f - yl G-
6. 7o~-
L 10
Description Initial System
Repair System
lvailable Space (.1945)
iystem Type(s)
Re LTAR (o
al ly
Property'.
Lot
File
Code:
Applicant:
Date Evalua(ed: -1/1-7/4
Property Size:
Property Recorded:
f J Well f J Spring [ I Other
[ J Pit [ J Cut
( J Industrial Process [ J Mixed
OTHER
PROFILE FACTORS
.1942
so,. .1943 19M , .19441'
bfMs
Weblew Sa; . Sapp Res& ie" Color IN.) Class Horlt AR
.~~f
iLT
Other Factors (.1946):
Site Classification (.1948):
Evaluated By: l!'~+
Others Present: