IPACHTE# (c~~`~a~`~~ Harnett County Department of Public Health 2 5 31 7
Improvement Permit
A building permit cannot be issued with only an Im rovement Permit
_ PROPERTY LOCATION: oc-'E2 ~ R
ISSUED TO: Hocnac!~' Q2C)Q SUBDIVISION 'ZN,
y, SjA K\L LOT #
NEW REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: S7-CJ Asa x aJ~
Proposed Wastewater System Type: Co NBC sv y a~
Projected Daily Flow: 3QC> GPD
Number of bedrooms: 3 Number of Occupants: max
Basement ❑Yes No
Pump Required: ❑Yes ❑ No X May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community tK Public ❑ Well Distance from well 100 feet Permit valid for. Five years
Permit conditions: ❑ No expiration
Authorized State Agent: Date: Ah. ~zS EE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantee a issuance of other permits. The perder isis esp
bl, for heckmg 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, A95S, .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: PROPERTY LOCATION: ROCE57S
SUBDIVISION °S 4- LOT #
Facility Type: New ❑ Expansion ❑ Repair
Basement? ❑ Yes 7D~ No Basement Fixtures? ❑ Yes No
Type of Wastewater System** Y c, t--4
_PL (Initial) Wastewater Flow: GPD
(See note below, if applicable
Co N vc7"~-.I_- (Repair)
Installation Requirements/Conditions Number of trenches 3-
Septic Tank Size 1 0o Q gallons Exact length of each trench ``a feet
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of. a~ inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
Pump Requirements: ft. TDH vs. GPM
Conditions:
Trench Spacing: Feet on Center
Soil Cover ~a inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
Aggregate Depth:
inches below pipe
inches above pipe
inches total
*If applicable: /understand the system type specified is different from the type specified on the app/ication. / accept the specif1cations of this permit.
Owner/Legal Representative Signature: Date:
This Construction Authorization is subject tQ-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 complianc~w r ions of the laws and Rules for Sewage Treatment and Disposal and to the conditions of this
SEE ATTACHED SITE SKETCH
Authorized State Agent: Q_5 (PL-NCB Date: Li
Construction Authorization Expiration Date: _
H T E # 0c) ~ ~c13 L- Permit # aS3l]
Harnett County Department of Y' iblic Health
Site Sketch
PROPERTY LOCATON: hoc CLS
ISSUED TO: ;acs M ~s Q SUBDIVISION ~Q~ es V~ ~T~~~~t L LOT #
Authorized State Agent L~~EsZ `SdL~s~c Date:
i-A`~tY~ Q4bC2
N cr; GLC~2 ~sj
Ov EV LUA~~~
rn
UcP- " "
Division of Environmental Health Property ID:
On-site Wastewater Section Lot
File
SOIL/SITE EVALUATION Code:
for ON-SITE WASTEWATER SYSTEM
Owner: Applicant:
Address:
Proposed Facility: QJ~oQ Q,r,, Design Flow (.1949):
Location of Site:
Water Supply: Public [ j Individual [ ] Well
Evaluation Method: _ "uger Boring Pit
Type of Wastewater: J"Aewage Industrial Process
Date Evaluated:
Property Size:
Property Recorded:
[ ] Spring [ J Other
( ] Cut
[ J Mixed
P
R
p
F
SOIL MORPHOLOGY
.1941`
OTHER
PROFILE FACTORS
1
L
E
#
1940
Landscape
Position%
Slope%
Horiior>
Depth
(IN.)
1941
Structure/
Texture
1941
Consistence
Mineralogy
.1942
Soil
Wetness)
Color
1943
Soil •
Depth (IN.)
1956
Saproc
Class
1944
Restr
Horiz
Profile
Class.
& LIAR
t
1-5
4 -4,
G 0
f ~2 r
s
C,-Z`'r'~
1+6°' T
5GL-.
V11 S5 )S
Description
Initial S tem
,-Repair System
Available Space (.1945)
System Type(s)
Site LTAR
'
Other Factors (.1946):
Site Classification (.1948): S
Evaluated By: G
Others Present:--