IPACHTE# Cf-i a~ky Harnett County Department of Public Health 2 5 4 7 4
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: ~sEa Qtrn-'o- , q-+~
ISSUED TO: - ~~C=c t-~ SUBDIVISION -Zt- i M R~Q*-N~-A 5Q_ LOT #
NEW X REPAIR ❑ PANSION ❑ Site Improvements required p6or to Construction Authorization Issuance:
Type of Structure: 0.00) Q3a:xl6
Proposed Wastewater System Type: Go -,,t Er r C ~n c~ o,x-
Projected Daily Flow: "%O GPD
Number of bedrooms: 4 Number of Occupants: `t3 max
Basement ❑Yes 'K No
Pump Required: ❑Yes -X No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community Public ❑ Well Distance from well fOU 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 er 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: l-EC W C t_c.5 PROPERTY LOCATION: p ossErr Q t,~ ,r\y" t 'Zo
SUBDIVISION _ ':5~tcz2y M LOT # 3
Facility Type: Moz L3a ''~G l X New ❑ Expansion ❑ Repair
Basement? ❑ Yes `JR,, No Basement Fixtures? ❑ Yes X No
Type of Wastewater System** C.d" vc-~svr-,r tkL (Initial) Wastewater Flow: GPD
(See note below, if applicable
Cd N y EN-~ ~o tv y-.I (Repair)
Installation Requirements/Conditions Number of trenches 3
Septic Tank Size t °a o gallons Exact length of each trench 90 feet Trench Spacing: Feet on Center
Pump Tank Size gallons Trenches shall be installed on contour at a Soil Cover: t inches
Maximum Trench Depth of: rats 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: to inches total
**If applicable: / andermand the system type rpeciTed it different from the type fpeci6ed on the application. / accept the specitcwonr of this permit.
Owner/Legal Representative Signature: Date:
This Construction Authorization is subject to revocano site p a , 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 sub' to compliance wi e~tv the s and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent: (8-5 Date: 5
Construc n Authorization Expiration Date:
HTE# O°~-S"a2d lt-} Permit # , LI 1}
Harnett County Department of Fl blic Health
ite Sketch
PROPERTY LOCATON: Rosser Q~~r,RN
ISSUED T0: b Es-- S SUBDIVISION _"SEcuz~t M Ao~~vs Sa LOT # 3
Authorized State Agent: ~o~ ~vG2 Sox sou Date: 51 i1) d e
(---N P-1-1 1 o Gpn C
C7 cv D.o'1 AcL- ~
`-q
Division of Environmental Health
On-site Wastewater Section
Owner:
Address:
Proposed Facility:
Location of Site:
Water Supply:
Evaluation Method:
Type of Wastewater
SOIL/SITE EVALUATION
for ON-SITE WASTEWATER SYSTEM
1-
Property ID:
Lot
File
Code:
Applicant:
Design Flow(. 1949): Eqo
.Public [ J Individual [ ) Well
Auger Boring [ ] Pit
''Sewage Industrial Process
Date Evaluated:
Property Size:
Property Recorded:
[ J Spring
[ J Cut
( j Mixed
P
R
o
F
SOIL MORPHOLOGY
1941
; OTHER
; PROFILE FACTORS
1
L
E
#
:.194Q
Landscape
Positlor /
Slope%'
orizon
Depth
IN.)
1941
Structural'
Texture
941,
' Consistence '
Mineral
.1942'
Sod
Wetness/ ;
Color
i_ 1943
SoN. ~
tfi' k.
958
Saptctr'
Class.
, , ,1944`
- Restr'
Horn,,_
36
34-LM
G
C)
G s
R ..t5\ r t'
.
s
4 F-11, -.3
~
O~
C S
Yt"2
X57 . 5u_
Description
Initial System
pair System
Available Space (.1945)
System Type(s)
Cr)rJ
Co rt
Site LTAR
'
2Gr' ~ tGt
Other Factors (.1946):
Site Classification (.1948): Q j
Evaluated By: O
Others Present:
[ J Other
S.1
aS
0 `
b