IPACHTE#o9 - s -221y1 Harnett County Department of Public Health 25410
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION•
ISSUED TO
n 14-f ~J-u ' e SUBDIVISION # J__
NEW REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure:
Proposed Wastewater Sys ' tem Ty e:
Projected Daily Flow: GPD
Number of bedrooms: Numbe of Occupants: max
Basement ❑Yes ❑ o
Pump Required: ❑Yes ❑ No M be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community Public ❑ Well Distance from well feet Permit valid for: Five years
Permit conditions: ❑ No expiration
Authorized State A nt: Date: SEE ATTACHED SITE SKETCH
The issuance of this permit Health Department in no way guarantees the issuance of other permits. The permit holder is responsible far checking with appropriate governing bodies in meeting their requirements. This
site is subject to revocation i 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: PROPERTY LOCATION:
SUBDIVISION LOT #
Facility Type: New xpansion ❑ Repair
Basement? ❑ Yes No Basement ixtures? ❑ Yes No
Type of Wastewater System** (Initial) Wastewater Flow: GPD
(See note below, if applicable
-(Repair)
Installation Re uirements/Conditions
Number of trenches
Septic Tank Size gallons
Exact length of each trench feet
Pump Tank Size gallons
Trenches shall be installed on contour at a
Maximum Trench Depth of- 2 r inches
(Trench bottoms shall be level to +1-114"
in all directions)
Pump Requirements: ft. TDH vs.
GPM
Conditions:
Trench Spacing: Feet on Center
Soil Cover: 4e Inches
(Maximum soil cover `shall not exceed
36" above the trench bottom)
Aggregate Depth:
Inches below pipe
inches above pipe
inches total
**If applicable: /under tand the system ty pe specified is different (nom the type specified on the application /accept the rpecificationr of this permit.
Owner/legal Representative Signature: Date:
This Construction Authorization is whiert in rPVnrlti- if rho a'tn a- nkt n, eh. ;-..a~a
- -,,,,6- ----till --all Vr uc ummerreu when mere is a mange in ownersmp of the site. Ihrs
construction Authorization is subject to compliance with the provisions of the laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit. SEE ATTACHED SITE SKETCH
Authorized State A t: Date:
Construction Authorization Expiration Date: - / -
HTE# l 5-- 2Zl ql Permit # ..2 5 11 C7
Harnett County Depar=tment of 1blic Health
Site 'S ketch
PROPERTY LOCATON: Aet/ Y
c ~/~',~j
ISSUED TO: ~ ~ ~e SUBDIVISION LOT # _
Authorized State A Date:
-339
A
tl~
y
~ 14a3 C~&5bu/zV Rlb~
vncoi.
Division of Environmental Health Property ID:
On-site Wastewater Section Lot
File
SOIL/SITE EVALUATION Code:
for ON-SITE WASTEWATER SYSTEM
Owner:
Applicant: 221y1
Address:
Date Evaluated:
Proposed Facility:
Design Flow (.1949):
/ v ~
Property Size:
Location of Site:
Water Supply:
14-Pubiic
(J Individual
[ J Well
Property Recorded:
Evaluation Method:
[ Au
er B
i
[ j Spring
[ j Other
g
or
ng
[ J Pit
[ ]Cut
Type of Wastewater:
I SmKwage
[ J Industrial Process (j Mixed
P
R
O
SOIL MORPHOLOGY
OTHER .
F
.1941
..PROFILE FACTORS
t 944
L Landscape Horizon
E Position/ De
th
- .1941
~ Stru
f
l ~
.1941
.1942:, r p
Sod 's 1943] 1956
194 Proflfe
p
# ' Slope96 IN.)
c
ure
Texture
Consistence
Mineral
-
Wetnesat'Saptoi
- Restr; Ctase'
Color Clepth° (IN.) Class , .
iiatr'- 3 LIAR `
l S% 6 TD
SL
L
L (e~
-Art
1l-yg
$GC.
6~ ii tP
~
L 7 ZY
st,
f<
7 ?:P
Description
Initial Sys m
Repair ystem
Available Space (.1945)
System Type(s)
~dv
fir..
Site LTAR
Other Factors (.1946):
Site Classification (.1948): /
Evaluated By:
Others Present: