IPAC RHTE#_45-} O-~1XIGY t2 Harnett County Department of Public Health 2 3 5 9 5
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: L
ISSUED TO: SUBDIVISION 61)7 Jnkl LOT # t*
NEW4` REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: ,5M- Tao x 5 - 3 0 r-
Proposed Wastewater System Type: 2 S L, /ft J - f` Sn j4~-
Projected Daily Flow: le D GPD
Number of bedrooms: Number of Occupants: max
Basement ❑Yes -40 No
Pump Required: ❑Yes ❑ No P~4- May be required based on final location and elevations of facilities
Type of Water Supply;,_❑ Community ,0 Pkblic 0 Well Distance from well feet
pons:
Permit valid for.
Five years
❑ No expiration
Authorized State Agent:. Ll Date: 01-/- 2-3 1t SEE ATTACHED SITE SKETCH
The issuance of this permit b the 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 accordant/ with the attached sy{tem layout.
ISSUED TO: ft I H ( 'cart, PROPERTY LOCATION: 11 2 -f-
SUBDIVISION O2a 7 O A k1 LOT #
Facility Type: Lo, 4 d ~ 13 a New ❑ Expansion ❑ Repair
Basement? ❑ Yes C~CNo Basement Fixturs s~? ❑ Yes 411,o
Type of Wastewater System' ~ 021 / (Initial) Wastewater Flow: ~ s GIRD
la 3
(See note below, if applicabl
(Repair)
lnsWWm Kequirmnts/Condifims
Septic Tank Size s gallons Exact length of each trench feet Trench Spacing: _ 2 Feet on Center
Pump Tank Size gallons Trenches shall be installed on contour at a Soil Cover 6 inches
Maximum Trench Depth of. a ` 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
Conditions:
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 specifications of this permit
Owner/Legal Representative Signature: Date:
Ihu Lonstrucnon Authorization is subject to revocation it 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 Auth n 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 Agent: ti- Date:
Construction Authorization Expiration Date: a~f ob
HTE# S~ - $ Permit # X 5 if
-ffiarnett County Department of Public Health
Site Sketch
PROPERTY LOfATON: [I t c
ISSUED TO: Q t-t SUBDIVISION r s~ aril' 3 LOT # i
Authorized State Agent: Date: 0't d~),
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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: Design Flow(. 1949):
Location of Site:
Water Supply: ublic [ j Individual [ J Well
Evaluation Method: Auger Boring [ J Pit
Type of Wastewater: ewage Industrial Process
Date Evaluated:
Property Size:
Property Recorded:
( ] Spring
[ ] Cut
( J Mixed
[ J Other
P
R
p
SOIL MORPHOLOGY
' .1941`
OTHER
PROFILE FACTORS
1
L`
E'
#
.1940
Landscape
Position/
Slope%
Horizon
Depth
(IN.)
.1941
Structure/
Texture
1941
Consistence
Mineralogy
.1942
Soil
Wetness/'
Color
'.1943.
Soil r
Depth (IN.)
.1956
Sapra
Class
.1944
Restr
Horiz
Profile
Class, ;
& 4TAR
v
J L
6/1
A
Description
Initial System
Repair SW ern
Available Space (.1945)
System Type(s)
Site LTAR
)
Other Factors (.1946):
Site Classification (.1948):
Evaluated By:
Others Present: