IPACHTE# Harnett County Department of Public Health 25461
Improvement Permit
A building permit cannot be issued with only an Improvement ermit
PROPERTY LOCATION: ~ ,
ISSUED TO: P SUBDIVISION LOT #
NEWX REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: mf-A . "O ~ - (a)-: , C' 'v )
Proposed Wastewater System Type: acv 4C-cv No
r i 4~,L
Projected Daily Flow: 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 A Public ❑ Well Distance from well 'i OQ~ feet ~ermit valid for. X Five years
Permit conditions: v Grp fl \ a
E(Z cDL QLLF°' k:) E-J o~- ❑ No expiration
Authorized State Agent:: R- _ Date: 5 0CA SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the issuan other permits. The permit hold it is sponsible 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 TO: Y-C-) 0 a r(' tM PrEL:~~ C`1~~~J PROPERTY LOCATION: QD
SUBDIVISION LOT # -D-
Facility Type: U NN . \A a~n E (~New ❑ Expansion ❑ Repair
Basement? ❑ Yes ' No Basement Fixtures? ❑ Yes No
Type of Wastewater System** -J 3-.4 f-,L, (Initial) Wastewater Flow: GPD
(See note below, if applicable
~L--sn~~~cat-cor~~~~ ptnvvs tar l (Repair)
Installation Requirements/Conditions Number of trenches 11
Septic Tank Size l C) o U gallons Exact length of each trench S O feet Trench Spacing: Feet on Center
Pump Tank Size gallons Trenches shall be installed on contour at a Soil Cover: 1 d inches
Maximum Trench Depth of. -al~ - 1`b 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. TON vs. GPM inches below pipe
Conditions:
Aggregate Depth: inches above pipe
inches total
"If applicable: l uadecrtand the ryrtem type rpecied is different from the type rpeci~ed on the application. l accept the rpecificationa o/thir permit
Owner/Legal Representative Signature: Date:
This Construction Authorization is subject to re if the site p Tat, 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 subect to compliance 'th the of the s and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent: Date: 5 1-71(?
Construc Authorization Expiration Date:"
HTE# Permit # 2~-54L 1
narnett ('ou~it Depar(ment of f'itblic Health
Site Sketch
PROPERTY LOCATON: 14
ISSUED TO: Le) cw% SUBDIVISION LOT # ~
Authorized State Agent:
Date:
M/
~
Division of Environmental Health
v. rova.
Property ID:
,
On-site Wastewater Section
Lot
File
SOIL/SITE EVALUATION
Code:
for ON-SITE` WASTEWATER SYSTEM
Owner:
Applicant:
Address:
Proposed Facility: Q1' M f :Design Flow (.1949)t
Date Evaluated
P
t
:
TD
roper
y Size
-
Location of Site:
Property Recorded:
Water Supply: Public (j Individual
'
[ J Well
[ 1 Spring
[ 1 Other
Evaluation Method: uger Boring
[ 1 Pit
[ j'Cut
Type of Wastewater ewage
[ 1 Industrial Process` [ j Mixed
P
R
o
SOIL MORPHOLOGY
OTHER
, .
F
.1941
PROFILE FACTORS
1
.194
1942:
f
L
Landscape
Horizon
1941
1941
Soil
, 1943
1956
1944
Profil
E
#
Position/
Slope%o
Depth
(IN
)
Structure/
T
t
Consistence
Wetness/'
Soil
Sapro
Restr
e
Class s.:.i;='
.
ex
ure
Mineralogy
Color
Depth (IN.)
Class
Horiz
&I.TgFt . s;'?r
z
t 5
_
~
2
,
3
ey
~
i
Description
Initial System
R air System
Available Space (.1945)
System Type(s)
Site LTAR
,
t
Other Factors (.1946):
Site Classification (.1948): S
Evaluated By:
Others Present: