IPACHTE# 001-5-aao3~. Harnett County Department of Public Health 2 5 4 7 p
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: T n 6Ecv Ro r-% A
ISSUED TO: QC5-MCL- cn15-1 Q,vC„1e3N SUBDIVISION -Z4'mc,s-, QrsgFttCSarv LOT #
NEW,, REPAIR ❑ E ANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: 5~ (,5`7'--35"
Proposed Wastewater System Type: Corvvr---S1XC- v-NL
Projected Daily Flow: 3C. C7 GPD
Number of bedrooms: Number of Occupants: ~o max
Basement ❑Yes No
Pump Required: ❑Yes X No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community 'X Public ❑ Well Distance from well ~b0 feet Permit valid for
five years
Permit conditions: ❑ No expiration
Authorized State Agent:: 25 Date: SI S3 0`1 SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the issuan 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: CIO ~,~-g~dty PROPERTY LOCATION: 77',,.,c~t„
SUBDIVISION 7P,-,Ss RO$~c2_~SOsJ LOT # IC5
Facility Type: 5F9 Ck New ❑ Expansion ❑ Repair
Basement? ❑ Yes ~K No Basement Fixtures? ❑ Yes XNo
Type of Wastewater System** Co C-4 J f--N! f ~-Q N SQL- (Initial) Wastewater Flow: 34a GPD
(See note below, if applicable
C-0 X of t P.L-- (Repair)
Installation Requirements/Conditions Number of trenches L~
Septic Tank Size tooo gallons Exact length of each trench rod feet
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of. ~.LA inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
Pump Requirements: ft. TDH vs. GPM
Conditions:
Trench Spacing: C~ Feet on Center
Soil Cover: la, inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
inches below pipe
Aggregate Depth: inches above pipe
S a inches total
**If applicable: l umderftaad the ryttem type rpeciled it different from the type ,peciled on the application. / accept the rpecilcationJ of thin permit
Owner/Legal Representative Signature: Date:
This Construction Authorization is subject to revocano site pIan, p`t 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(Ipject to compliance wiNt~ oJ~~tf~tb and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent: Date: 51)31
Construction orization Expiration Date:
HTE# Q'i Permit # 264-IC)
Harnett Connty Department of Public Health
Site Sketch
ISSUED TO: N
Authorized State Agent:``
PROPERTY LOCATON: KN(Z.6-4"j 3"oKy
SUBDIVISION ~e~mF-5 Qojgp;zso,j LOT #
> >a'
~o D ~ 6?..oe.EsLiS W
ao
Division of Environmental Health
On-site Wastewater Section Property ID:
Lot
File
SOILISITE EVALUATION Code:
for ON-SITE WASTEWATER SYSTEM
Owner:
Applicant:
Address:
Proposed Facility:
Design Flow (.1949):
Date Evaluated:
Location of Site:
Property Size:
Water Supply:
Public
(j Individual
(j Well Property Recorded:
Evaluation Method:
Auger Boring
( J
[ ]pit Spring
(j
Other
Type of Wastewater:
ewage
Cut
[ j Industrial Process
[ J Mixed
P
R
o
SOIL MORPHOLOGY
F
OTHER
1
• ~ 94q ,
119411
PROFILE FACTORS:
L
Landscape Horizon
1941, "
,1941
.1942
Soil
E
#
PasitioN, Depth
Si
, < Structure(
Consistence
1943.1936 ,1944w
Wetness! Sod: 5
t's
h
Profile ti t r
op,6% IN.)
TezWro
Mineral
a
a
P Restr;
Color; ' dep61 IN
ti H
) Clas
Class
.
s
orn
& LTAR
Sgt' Sri,
~ ss l t~
f~
ilable Space (,1
p-Q Li* G 5
r _
r~ ~a5 u r.~_ r4
( IL G
t 6-4ml t y-G(T
Initial
it System
oysiem i ypets) CU n/ C Q tJ
Site LTAR
Other Factors (.1946):
Site Classification (.1948):
Evaluated By: Q
Others Present: -0 Nl 1e-n