IPACHTE# Harnett County Department of Public Health 2 5 4 5 9
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: 11 NGIE-N ISSUED TO: V- ~'7'~ s ut~ E~- Ct(LV SUBDIVISION `~sc-',ic-r-,., it kc LOT # t _
NEWX REPAIR Q E~ANSION 11 Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: S FP 3 x~,
Proposed Wastewater System Type: 1~4 E"- eWlN~
Projected Daily Flow. GPD
Number of bedrooms: 3 Number of Occupants: max
Basement ❑Yes No
Pump Required: ❑Yes ❑ No ,May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community X Public ❑ Well Distance from well 10(~) feet
Permit conditions:
Permit valid for. Five years
❑ No expiration
Authorized State Agent:: ~Z~r~~~~~ Cdr Date: '1 ~Z/ 0"J SEE ATTACHED SITE SKETCH
The issuance of this permit by 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, .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: l~sS 1 c~sr~s ~~,aP PROPERTY LOCATION: ~t~,ct R
SUBDIVISION 7-t~~ P~ acE LOT # 5ZJ _
Facility Type: 2S,, New ❑ Expansion ❑ Repair
Basement? ❑ Yes No Basement Fixtures? ❑ Yes XNci
Type of Wastewater System** (10 0-4 C- (Initial) Wastewater Flow: 3C Q GIRD
(See note below, if applicable
cw set t'l t>, i.__ (Repair)
Installation Requirements/Conditions Number of trenches Z_
Septic Tank Size lOc> gallons Exact length of each trench -l S` feet
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of. aO-3t- 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. 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 it different from the type rpeci6ed on the application. /accept the specifications of this permit
Owner/Legal Representative Si re: Date:
This Construction Authorization is subject to revocation i ite p 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 s compliance wi e s ws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent: S~ Date: 5 ~ 0
Construe ion Authorization Expiration Date: S
HTE# Q`\ Permit #
Harnett County Mpa latent of 1'tiblic Health
Site Sketch
ISSUED TO:
Authorized State Agent:
PROPERTY LOCATON: ►~6 V-2)
SUBDIVISION N ~F Q LsS c_~( LOT # 5_
>19~w~stw~~c~bo~~ Date: I0~1
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2EPv,~cZ, ~2~
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Division of Environmental Health y y y V 1 `yJVy ~J
On-site Wastewater Section
SOIL/SITE EVALUATION
for ON-SITE WASTEWATER SYSTEM
Owner:
Address:
Proposed Facility: fj~ to Design Flow (.1949):4
Location of site:
Water Supply: 'Public
of rt;at.
Property ID:
Lot
File
Code:
Applicant: fi ! ~ k~'S
!1 Date Evaluated:
Property Size:
Property Recorded:
[)Individual Well Spring
Evaluation Method:Auger Boring O Pit
Type of Wastewater. ksewage [ )cut
[)Industrial Process
4vailable
iite LTAR
( ) Mixed
Other Factors (.1946): _
Site Classification (.1948): S
Evaluated By: O
Others Present:
[ ] Other