IPACHTE# dct-s-a~9%5 Harnett County Department of Public Health 2 5 4 7 2
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: KC4 aN-1- 0a,
ISSUED T0: WEav~ tZ fl~yE> c~F,TI SUBDIVISION SvN scc'~ R.o cfd LOT # k._7
NEW REPAIR ❑ ~EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: 5 F9 (Sto x5o' l
Proposed Wastewater System Type: C_otvy6 ev~1 0 V-1
Projected Daily Flow: 3G0 GPD
Number of bedrooms: Number of Occupants: ~O max
Basement ❑Yes No
Pump Required: ❑Yes No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: El Community ~ Public ❑ Well Distance from well )nO feet Permit valid for: ~ Five years
Permit conditions: No expiration
Authorized State Agent.: ~w Date: 5 lY, ( 4SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Depa ent in no way guarantees the issuance of oth r he permit holder is re ponsible 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 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, 1957, .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: ~EA•~cCL ~E c~~rcf~ PROPERTY LOCATION: ~n-.
SUBDIVISION SU-, ~ R\oCE. LOT # UY
Facility Type: S0 New ❑ Expansion ❑ Repair
Basement? ❑ Yes No Basement Fixtures? ❑ Yes No
Type of Wastewater System' Co~.,vt~. \a N P' (Initial) Wastewater Flow: GPD
(See note below, if applicable
C-10 vSr-r"%NUNp4_ (Repair)
Installation Requirements/Conditions Number of trenches
Septic Tank Size X000 gallons Exact length of each trench S5C~) feet Trench Spacing: c1 Feet on Center
Pump Tank Size gallons Trenches shall be installed on contour at a Soil Cover: inches
Maximum Trench Depth of. aL1- 3 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: S c~ inches total
**If applicable: /understand the system type rpecifled is different from the type specified on the application. / accept the specifications of this permit.
Owner/Legal Representative Signature: Date:
This Constiuctton Authorization is subject to re on if the site la or the intended use changes. The Construction Authorization shall not be transferred when there is a change in ownership of the site. This
t
Construction Authorization is subject to compliance withprov f t and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent: Q-S Date: 5
Construction horization Expiration Date:
HTE# Cy:" -SPermit # a
Harnett County Department of lNiblic Health
i te'Sketell
PROPERTY LOCATON: pl*41 N e '-L.
ISSUED TO: ErcL ~ ~-oQr►~~ SUBDIVISION SoNsE-c '~,,o-~E LOT # 1`h'
Authorized State Agent 4-5 ~Q~~~Ea ~oDate:
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Division of Environmental Health Property ID:
On-site Wastewater Section Lot
File
SOIL/SITE EVALUATION Code:
for ON-SITE WASTEWATER SYSTEM
Owner:
Applicant:
Address:
Date Evaluated: 51 1 _110
Proposed Facility:
vF.U
Design Flow (.1949):'~
Property Size:
Location of Site:
Water Supply:
[Public
[ j Individual [ ] Well
Property Recorded;
Evaluation Method:
__N Auger Boring
[ j Pit
Spring
[ j Other
Type of Wastewater:
l y``Iewage
jj
[ j Cut
[ j Industrial Process
[ j Mixed
P
R
o
SOIL MORPHOLOGY
OTHER.
:
F
.1941
= PROFILE FACTORS-
L Landscape Horizon
.1941
1941
.1942:
.
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:
E Position/ Depth
S
, Structure!
Consisience ' -
1
943
.1956 ,1944'
Watoessh : c Sod`; Sa
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Texture
Mineral
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Cam' th IN.) - Class ~'~l
it'
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Description
Initial System pair System
Available Space (.1945)
System Type(s)
CO,"
Site LTAR
g
Other Factors (.1946):
Site Classification (.1948):
Evaluated By:
Others Present: v\