IPACFITE#Q)cI Harnett County Department of Public Health 2 5 4 6 7
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: N 1> LMe rs C G- Q-0
ISSUED TO: Ly" o n 0 c y SUBDIVISION LOT #
NEW,, REPAIR ❑ EX~ANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: 0P~r--~ . AA0m1
Proposed Wastewater System Type: G? -4 -4 c ~ ~Oiv 1
Projected Daily Flow: GPD
Number of bedrooms: Number of Occupants: Q;1 max
Basement ❑YesI No
Pump Required: ❑Yes ❑ No 9May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community ❑ Public ❑ Well Distance from well feet Permit valid for. Five years
Permit conditions:
❑ No expiration
Authorized State Agent:: Date: 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, .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: V--Y6 woc?c~) ya.; ,•'cjc.
Facility Type: rVcN
Basement? ❑ Yes No Basement Fixtures
Type of Wastewater System** C'orrvE_r' c\cs
(See note below, if applicable
PROPERTY LOCATION: t1sLLCRn.v Cxto~E- R
SUBDIVISION LOT #
New ❑ Expansion ❑ Repair
❑ Yes X No
P, L
'D'❑°l~ }~ovc ~lO~f ~JysSC*~ (Repair)
Installation Requirements/Conditions Number of trenches IZI-
Septic Tank Size 1 C7(7v-) gallons Exact length of each trench feet
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of: al-A inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
Pump Requirements: ft. TDH vs. GPM
Conditions:
(Initial) Wastewater Flow:_ GPD
Trench Spacing: Feet on Center
Soil Cover: inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
inches below pipe
Aggregate Depth: inches above pipe
inches total
**If applicable: / understand the system type specified is different from the type specified on the applbaon. / accept the specipcations of this permit
Owner/Legal Representative Signature: Date:
This Construction Authorization is subject-"vacation 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 su~ject to (ompliarr ~'tfi th of the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit. SEE ATTACHED SITE SKETCH
p -
Authorized State Agent: t RZ)
Date:
Constru n Authorization Expiration Date:
HTE# Permit #
Harnett ('ounty I)epartment of ll ~ibl is Health
Site Sketch.
PROPERTY IOCATON:_ \C-
ISSUED T0: SUBDIVISION
LOT #
Authorized State Agent: (~w, cx a~s~cY;arP t~~4 eA
4:z~,
i1 iLLrn~ v Gt-c;vF jZ„i
uepartmetlt us GIv11uII111Cl1t. riCdlUl, dllu IVdWldl neJVul L&b
Division of Environmental Health
Of lt~vt
.
On-site Wastewater Section
ld
Property y IC(
Lot
SOIL,SITE EVALUATION
File
for ON-SITE WASTEWATER SYSTEM
Code:
Owner:
Applicant:
Address:
A
Proposed Facility:
_j rocs- a)o(-IC Design Flow (.1949):-340)
Date Evaluated:
j
/ °
Location of Site:
Property Size:
Water Supply: [ j Public [ ]Individual [ Well
Property Recorded:
Evaluation Method:
[ ]Auger Boring [ j Pit
Spring
[ j Other
Type of Wastewater: [ j Sewage
[ j Indus
trial Process
Cut
(j Mixed
P
O
SOIL MORPHOLOGY
tsar
OT
HER
I
1 .1940
PROFILE
FACTORS
L Landscape
Horizon
.1941
1941
1942
E Position/
Depth
.
Sf tduret Conslabnce
Wetnso#
ssa/
AM .1956 x
..19"
Profile r_.
Slope% IN.) Texture
Color
Son/ , Sapra, t
Restr
Class
d C L f t~~ l~~
fh M•) Chas
koria
& LTAR
1
-
j
C
~GFP~
~_c
G
,
~vJ-., wI
3 3~X
Ptr
~
~CL 355
C
~ 5
v~7t ~.,5 P
Description Initial System Repair Sy
kvailable Space (.1945)
iystem Type(s) G° S`1e 'Qf?X__~,
site LTAR
Other Factors (.1946):
Site Classification (.1948): f_~)
Evaluated By: (5~ f ec-,)
Others Present:
G ~v
vg
~ X