IPACHTE#d4-s-Z19g7 Harnett County Department of Public Health 2 51 3 8
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION:S~C /LCb
ISSUED TO 1,) c, P~, SUBDIVISION r.Jd a/p LOT # -
Q-NEW G, REPAIR ❑ EXPANSION ❑ Site provements required prior to Construction Authorization Issuance:
Type of Structure: SF~L
Proposed Wastewater System Type: z5 irZ.~AtJGiZ6~!ftC r 0r-t--
Projected Daily Flow: G PD
Number of bedrooms: Number o Occupants: 6=, max
Basement ❑Yes No
Pump Required: ❑Yes ❑ No May~(fe required based on final location and elevations of facilities ~
Type of Water Supply: El Community Public ❑ Well Distance from well feet Permit valid for. Z Five years
Permit conditions: ❑ No expiration
Authorized State A Date: Y-/y-'0 SEE ATTACHED SITE SKETCH
The issuance of this permit by a 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, 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 T0: ~z ~S/?'~f Sa~J(STi 97l T @ PROPERTY LOCATION: sg 176 / %,4kn-~ im
SUBDIVISION ife /t' 4 LOT # L
Facility Type: ZNew - Expansion ❑ Repair
Basement? ❑ Yes No Basement Fixtures? ❑ Yes No
Type of Wastewater System** IS°ln/Z-~-J~LJOQ A &rxYl-kA-t- < j4CC.~~ (Initial) Wastewater Flow: GPD
(See note below, if applicable i r
L ~°le /2/c~(J c~Z~1 Sts V (Repair)
Installation Requirements/Conditions Number of renches _ 3
Septic Tank Size / Ob b gallons Exact length of each trench feet
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of: 2 1r/ytriches
(Trench bottoms shall be level to +1-114"
in all directions)
Pump Requirements: ft. TDH vs. GPM
Conditions:
Trench Spacing: Feet on Center
Soil Cover: inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
Aggregate Depth:
~Q inches below pipe
.Z inches above pipe
inches total
**If applicable: /understand the system type specified is different from the type specified on the application. l accept the specifications of this permit
Owner/Legal Representative Signature: Date:
III IJI-L If „ULI-11aOOn is wujeu to revocation it me site plan, plat, or the mtenttett use changes. the Lonstruchon 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 Age • Date: q-fy - 0
Construction Authorization Expiration Date: H - !~(-J y
HTE# ? 1817 Permit # a 51-3cS
Harnett County Depa luient of Public Health
Site Sketch
PROPER LOCATON:_y 1"7O
ISSUED TO: / <<Sf ~~TC ~rnJ S~q*ISION LOT # Z--
Authorized State Ag Date:
I SIX
a
1
C3~U< row
Sl2 /76y i r h,,, o
uepartn lu I It ui -lv llviuucn~,
Division of Environmental Health
On-site Wastewater Section
Owner:
Address:
Proposed Facility:
Location of Site:
Water Supply:
Evaluation Method:
Type of Wastewater:
SOIL/SITE EVALUATION
for ON-SITE WASTEWATER SYSTEM
Property ID:
Lot
File
Code:
Applicant: Z116,47
Date Evaluated: f-/5/0-7
Design Flow (.1949): ~36 0 Property Size:
Property Recorded:
[tyblic [ j Individual (j Well [ j Spring [ ] Other
( )/Au er Boring (J Pit [ ] Cut
[ age [ j Industrial Process (j Mixed
P
R
o
F
SOIL MORPHOLOGY
.1941
OTHER
PROFILE FACTORS
1
L
E'
#
.1940
Landscape
Position/
Slope%
Horizon
Depth'
(IN.)
.1941
Structure/
Texture
1941
Consistence
Mineralogy
.1942::-
Soil .
WetnessP
Color
`.1943
Soil
Depth, (IN.)
195.6
5apra'
Class
1944
Restr
= Horiz
Profile
Class.
<AR
(
4 ' $
SL
~ /L
L
L ado
g- y 2
.sGC.
~ s-rr,
" ~'s'y~
~ 3
1
L ~f
G -JD
SG
G /~sTt
30
y
Description Initial Sys Repair Sy>Wn
Available Space (.1945)
System Type(s)
7iS°lb
Z6-*Vb
Site LTAR
3
3 7 y
Other Factors (.1946):
Site Classification (.1948):
Evaluated By: ~lZs~
Others Present: