IPAC RRNTE#
07,5 oc~- I-775'2 2Harnett County Department of Public Health 2 5 5 0 4
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION
ISSUED T : U A - SUBDIVISION r C-_) J ~a LOT # NEVIt;K REPAIR ❑ EXPANS N ❑ Situ provements required prior to Construction Authorization Issuance:
Type of Structure: _rr U - Ga X 0-
Proposed Wastewater System T pe: U J 1_-- s a trx
Projected Daily Flow: 3~ U GPD
Number of bedrooms: Number of Occupants: __max
Basement ❑Yes ti4-No
Pump Required:-O1es ❑ No May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community Public ❑ Well Distance from well 00 feet Permit valid for: ®'Five years
Permit conditions: {c C7n 5-+C LcA~,'3-_ ❑ No expiration
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S` _1 *4 l 1) f r V%a I M T!!A r r 9 f`~ M rl-~ti AoJ- 6- S L I na ( /3'1 U J T i lea v I k r" 6 12 x"0'7' ve>/'-"
Authorized State Agent:: " Date: .S'- t'i- 3 9 SEE ATTACHED SI E SKETCH
The issuance of this permit by the ne th Department in noway 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: ~ n PROPERTY LOCATION: S/t 0 L
SUBDIVISION et.~.~rs ~ S LOT #
Facility Type: WJ Ie~S 'xQ(L New ❑ Expansion Repair
Basement? ❑ Yes )Z- No Basement Fixtures? ❑ Yes ~2No
Type of Wastewater System" VV4-,n -f- c., Ikc c V- 6A (Initial) Wastewater flow: 3 GPD
(See note below, if applicable)
L'J2, a " ~r" ~ " (Repair)
Installation Requirements/( . onditions Number of trenches _ X
Septic Tank Size 0_'> O gallons Exact length of each trench _n_ feet
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of 1_2- inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
Pump Requirements: ft. TDH vs. GPM
Conditions:
Trench Spacing: Feet on Center
Soil Cover. G f`iAes T, ut
(Maximum soil cover shall not exceed &Z o-
36"
36" above the trench bottom) °Zn
inches below pipe
Aggregate Depth: 2 inches above pipe
inches total
**If applicable: /understand the system type specified is different /ram the type specified on the app/iwion. / accept the tpeci6cationr of this permit.
Owner/Legal Representative Signature: Date:
1.- ~ , - p'aa F." ~ we micnueu use tnanges. ine construction numonzanon snail not he transferred when there is a change in ownership of the site. This
Construction Authorization is subject to co ian with the provisions of the taws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent: ) Date: 05'- 11- J1
Construction Authorization Expiration Date: f " S S - 1
HTE# 13,7 -1-7 Y 52 a /t-- Permit # o? T3-0 q
Harnett County Department of Public nealth
Site Sketch
ISSUED T0: PROPERTY LOCATON: S c
SUBDIVISION (~l~> LOT #
Authorized State Agent: Date: ` !
Fr, f
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Division of Environmental Health Property ID:
On-site Wastewater Section Lot *
Fib k
SOIL,SITE EVALUATION Code:
for ON-SITE WASTEWATER SYSTEM
Owner. f} ('OJ t r / 2 a(", Applicant:
Address: Date Evaluated:
Proposed Facility: Design Flow (.1949] Property Size:
Location ofSite: Property Recorded:
Water Supply: pJI.Publc Individual ( J WON (1 Spring [ j Other
Evaluadw Method: ,(d_¢ugsr Boring Pit (J Cut
Type of Wastewater: if sewape Industrial Process Mixed
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Description Initial System Rep.
Ivailabie Space (.1948)
stem Type(s) / t),l
'te LTAR
tern Other Factors (.1948):
Site Classification (.1948): )
Evaluated By: l J
nw,a.. o.ses.,•.