IPACHTE# Q~ -5-- 2-211 Harnett County Department of Public Health 2 5 4 0 9
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCA`flft /'r
ISSUED TAY' SUBDIVISION 1 ~u Ix ' 41E,vd.~•c LOT #
NEW REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: S r 1J
Proposed Wastewater System Type: Cd,Jtlc.w,y-t-~
Projected Daily Flow: 3 1";1Z GPD
Number of bedrooms:
-
Basement ❑Yes
Z
No
Pump Required: ❑Yes
❑ No
Type of Water Supply:
❑ Community
Permit conditions:
NuZe ber of Occupants: 6 max
required based on final location and elevations of facilities
IL1 Public ❑ Well Distance from well feet
Permit valid for.
D- ive years
❑ No expiration
Authorized State Age Date: _ SEE ATTACHED SITE SKETCH
The issuance of this permit by Health Deparnnent in no way 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, ASS, .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: A4~ PROPERTY LOCATION: -S:t1V,1a0 ci e4' - /eA
SUBDIVISION / Cay).r- Z-)c c_/ LOT # L1
Facility Type: r- 1-Z New Z Expansion ❑ Repair
Basement? ❑ Yes No Basement F=' ❑ Ye L~ No
Type of Wastewater System' Cep u (Initial) Wastewater flow: 3 60 GPD
(See note below, if applicable
(Repair)
Installation Requirements/Conditions Number of trenches 3
Septic Tank Size / b0 U gallons Exact length of each trench 46' feet
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of. <311 ' 1 'p inches
(Trench bottoms shall be level to f/-1/4"
in all directions)
Pump Requirements: ft. TDH vs. GPM
Conditions:
Trench Spacing: 7 Feet on Center
Soil Cover inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
inches below pipe
Aggregate Depth: Z inches above pipe
1Z inches total
If applicable: /understand the system type ipecided is different from the type specified an the app/ration. / accept the speci//'catiana of this permit.
Owner/legal Representative Signature: Date:
1-1- W terueuuuu it me site plan, prat, or the mtenaea use changes. ine construction Authorization shall not be transferred when there is a change in ownership of the site. This
Construction Authorization is subject to compliance with the provisions of the laws and Rules for Sewage Treatment and Disoosal and to the conditions of this permit. SEE ATTACHEn SITE SKETCH
Authorized State Ag C Date: 1 - Z S - 65
Construction Authorization Expiration Date: 5 -2-1 - lf~
HTE# 6n- S'- 22- l 1 Permit # Z S `/G f
naniett County Department of I1liblic nealth.
Si tc S ketch
PROPERTY LOCATON:5X/
ISSUED TO: ssaiza SUBDIVISION LOT #
Authorized State A Date: Z~ - U c1
1,5
N
~J
XA)
N
400
U
ati
5
v, rooa.
Division of Environmental Health Property ID:
On-site Wastewater Section Lot
File
SOIL/SITE EVALUATION Code:
for ON-SITE WASTEWATER SYSTEM
Owner:
Applicant: 227116-
>
Address:
Proposed Facility:
Location of Site:
Water Supply: [ Public
Evaluation Method: [ uger Borin
Type of Wastewater: ( 4-Sewage
Design Flow(. 1949):
Individual
g
3&-16
[ J Well
[ it
[ J Industrial Proce
_
Date Evaluated: 5_'Z6_6,7
Property Size:
Property Recorded:
[ J Spring
[ j Other
[ j Cut
ss
[ j Mixed
P
R
o
F
.1940
SOIL MORPHOLOGY
.1941
3 OTHER
PROFILE FACTORS
L
E
Landscape
Po sition
Slope%
Hod;=
Depth
IN.)
1941"
Sh
ucturel
Texture
1941
Consistence .
Mineral
gly
.1942.
Soil -
Wetness/
Color -
,1943
Depth' IN.)
.1958
Sa
Pft'
Class
jhorii:'
ro$t+!
lass
1,TAR
L L %
d - ya
sf-
6ffl~L .,~17
a -Y'T
a
z~,t
~
.
o - a
-ir-C _0
Ac-
Z
3
40 46 SC,4-
L
_T
_
Description
Initial Syst
Repair Sy m
Available Space (.1945)
System Type(s)
CO-
Site LTAR
`7
?
Other Factors (.1946):
Site Classification (,1948): 5
Evaluated By:
Others Present: