IPACHTE#O r~ --5-a~~, Harnett County Department of Public Health 2 5 4 5 6
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: 14
ISSUED T0: SUBDIVISION ~b2Cs~ C FMS LOT #V> ,
NEW'14 REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure:
Proposed Wastewater System Type: C~ C-i ~E.-r a is L
Projected Daily Flow: 3~C-) GPD
Number of bedrooms: 3 Number of Occupants: Q, max
Basement ❑Yes 'X No
Pump Required: ❑Yes XNo ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community Public ❑ Well Distance from well koo feet Permit valid for. 1" t Five years
Permit conditions: - , ❑ No expiration
Authorized State Agent:: Date: S (3 SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the issua f other permits. The permit holder is esponsible 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, .1 9S7, .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. CAI~~tv-+c:7s s r~ ~wu.~,P~ PROPERTY LOCATION:
SUBDIVISION t`aQ-S~,, CSRvc5 LOT # I_
Facility Type: cLA a c New ❑ Expansion ❑ Repair
Basement? ❑ Yes -4 No Basement Fixtures? ❑ Yes `1~ No
Type of Wastewater System** (710 IN IJ (Initial) Wastewater Flow: 3~0 GPD
(See note below, if applicable
(Repair)
Installation Requirements/Conditions Number of trenches 3
Septic Tank Size 1 c, gallons Exact length of each trench ~d feet Trench Spacing: Feet on Center
Pump Tank Size gallons Trenches shall be installed on contour at a Soil (over: C- inches
Maximum Trench Depth of. 1% '30 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
inches below pipe
Aggregate Depth: inches above pipe
Conditions: T-~ ~ A ~ ~s ~ CSC t ~>,L-,iKV ~01A inches total
**If applicable: /understand the system type specified /s different from the type speci(ed on the app/ication. / accept the specifications of this permit
Owner/Legal Representative Signature: Date:
tms t.onsaucnon Aumonzanon is subject revocation it the sit Ian, 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 to compliances visions e Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent: Date: ~5 5 oCl
Cons ion Authorization Expiration Date: c S" ~9
HTE# Q-) -S a~cl S-G Permit # ~
Harnett County Department of Public Health
Site Sketch
PROPERTY LOCATON: Lc-moc--j. g S~L~ QD
ISSUED TO: ~t>v4 T-t~L-S 4.•w Q~~ SUBDIVISION 'VoIt.C, Q LOT #
Authorized State Agent:
Date:
t~
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Division of Environmental Health Property ID:
On-site Wastewater Section Lot
File
SOIL/SITE EVALUATION Code:
for ON-SITE WASTEWATER SYSTENI
Owner:
Applicant:
Address:
Date Evaluat
d
Proposed Facility: 3 S,,
e
:
Design Flow (.1949): Property Size: ttt
Location of Site:
\ Property Recorded:
Water Supply:
Public
Individual
[ i Well [ ] Spring
[ j Other
Evaluation Method:
Auger Boring
[ ] Pit [ ] Cut
Type of Wastewater:
~y 8ewage
[ ] Industrial Process (J Mixed
P
R
O
SOIL MORPHOLOGY
OTHER
F
.1941
i .
~ PROFILES FACTORS:'
1 .1940
.11942.',
L Landscape Horizon
E Position/ Depth
.1941
Structure!
1941
'Con
istenc
<
Soli A 943 1956 , 1944`•
Profile
# Slope% IN.)~
Texture
s
e
Mineralogy
Wetness/0 ; Soft= f ; SaPrbt' Restr:.
Color Depth, (IN
) Class
H
n
Class .
.
, -
or
6LIAR
lv~
Description
Initial System
epair System
Available Space (.1945)
System Type(s)
Cup r
~-`s% 6z
ISite LTAR
,T-~
Other Factors (.1946):
Site Classification (.1948):
Evaluated By.Qr
Others Present: