IPACHTE# Harnett County Department of Public Health 2 5 4 6 9
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: Viwy 40 ja
ISSUED TO: ~oQtvP.~A^J ko~,ES LLG SUBDIVISION
LOT #
NEW^ REPAIR ❑ F ANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: SF SJ ~5q 11C 10
Proposed Wastewater System Type: (lp r,- r,-rlON aL-
Projected Daily Flow: 3b GPD
Number of bedrooms: 3 Number of Occupants: max
Basement ❑Yes )KNo
Pump Required: ❑Yes X No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community 1XI Public ❑ Well Distance from well tpp feet
Permit conditions:
Permit valid for.
Five years
❑ No expiration
Authorized State Agent: Date: _ 113 1 acl SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the issuance they 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 Improvemen 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: "on,rqeoay 1Ao+-, -s, LLL
Facility Type: ~ New
Basement? ❑ Yes No Basement Fixtures? ❑ Yes
Type of Wastewater System** C.o ENS o t~ a
(See note below, if applicable
Co r-V c-_C'm k n N A L_ (Repair)
Installation Requirements/Conditions Number of trenches
Septic Tank Size ltd cc) gallons Exact length of each trench -IS- feet
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of. a Li inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
Pump Requirements: ft. TDH vs. GPM
Conditions:
(Initial) Wastewater flow: 3~6 GPD
Trench Spacing: Feet on Center
Soil Cover: S inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
Aggregate Depth:
inches below pipe
inches above pipe
V inches total
**If applicable: / understand the system type speciped is different from the type specified on the application. / accept the speci6catronr of this permit.
Owner/Legal Representative Signature: Date:
This Construction Authorization is subject to evocat on if the site pl%4at, 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 subjejjS2mpliance witl rdyieq~of to ws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
PROPERTY LOCATION: Hwy ~-}b )
SUBDIVISION LOT #
❑ Expansion ❑ Repair
_Z1,No
Authorized State Agent: Date: 51)31
Const n Authorization Expiration Date: S
HTE# Permit # aSL}6q
Harnett ('ounty Department of I'tiblic nealth
Site slzetch
ISSUED TO:
Authorized State Agent:
PROPERTY LOCATON: Nw~O
_ SUBDIVISION LOT #
Date: 5 1310 G)
Division of Environmental Health Property ID:
On-site Wastewater Section Lot
File
SOIL/SITE EVALUATION Code:
for ON-SITE WASTEWATER SYSTEM
Owner:
Applicant:
Address:
Proposed Facility: t \o v.,~
Design Flow (.1949): 6t pc3
0
Location of Site:
Water Supply:
,[Public
Individual [ ]Well
Evaluation Method:
Auger Boring
[ ] Pit
Type of Wastewater:
Sewage
[ ] Industrial Process
Date Evaluated: 5)
Property Size:
Property Recorded:
[ ) Spring [ j Other
Cut
(j Mixed
P
R
o
F
SOIL MORPHOLOGY
.1941
i OTHERS
PROFILE FACTORS:'
L
E
#
11940
Landscapes
PositioN, .
SioM%
Hork6r;
Depth
IN.)
.1941 "
, Structure[
;
Teic
ture
194[
`Consisten
ce
Mineralogy
•1942
Sod
.
Wetr►ess/ .
olor
943
Sot#
epth (IN.)
.1956
apha `
Class .
, 1944
estr;`.
~iorit -
i
Profile
C
LTAR
L~
Description
Initial System
Repair System
Available Space (.1945)
System Type(s)
Ga -,t
C-_,J
ISite LTAR
'
--t$"
Other Factors (.1946):
Site Classification (.1948): S
Evaluated By: G 1
Others Present: lDnj