IPAC RRHTE# )-3 - 1 P3I ~~-Harnett County Department of Public Health 2 5 5 0 6
Improvement Permit
A building permit cannot be issued with only a rov ment Permit
i l PROPERTY LOCATION: I / J 1-f
ISSUED F SUBDIVISION C ~ n J LOT #
NEV REPAIR ❑ EXPANSIO Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: )t `f
Proposed Wastewater System Type: Ow'p -r - 2 c~ r 1
Projected Daily Flow: t.3 ^APD /
Number of bedrooms: 0-AX Number of Occupants: to max
Basement ❑Yes -:15 No
Pump Requiredes El No El May be required based on final location and elevations of facilities
Type of Water upply: ❑ Community ;2~ Public ❑ Well Distance from well feet Permit valid for. Z Five years
Permit conditions: 4- 'T :k " s r ❑ No expiration
/ 1 i ~1 A t v~ rf~t ~ l SL c i ~ le 1 11e r-~ A it r Im LA A e.--, -E A yrs.
Authorized State Agent:: IL- J ` 3 _ Date: Q h ` O J - J l SEE ATTACHED SITE SKETCH
The issuance of this permit by the a Department 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 si 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, .1957, .1958. and .1959 are incorporated by references into this permit and shall be met. Systems shall be installed in accordance
with the attached s Dyout
ISSUED TO: r\ n c PROPERTY LOCATION:
SUBDIVISION CgM r tIJ,~ i"T t I LOT #
Facility Type: , F-D- New ❑ Expansion ❑ Repair
Basement? ❑ Yes ok No Basement Fixtures? ❑ Yes tel4'0-- Typ
e of Wastewater System** Qr► 2 Y, P", 4 j Amn (Initial) Wastewater Flow: GPD
(See note below, if applicable.
Installation Requirements/Conditions Number of trenches
Septic Tank Size 'Z3 ` 3 gallons Exact length of each trench liso, feet Trench Spacing: / Feet on Center
Pump Tank Size D 30 gallons Trenches shall be installed on contour at a Soil Cover. inches
Maximum Trench Depth of. 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: inches total
**If applicable: / understand the system type specified is different from the type specired on the application. / accept the speci6cationr of this permit
Owner/legal Representative Signature: Date:
[fill lonarutt[on Mumoradtion is suutea to revocation a me site plan, plat, or the mtenaea use changes, the tonstructron Authorization shall not be transferred when there is a change in ownership of the site. This
Construction Authorization is subject to co ance 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 Agent: ~ Date: G ' 0;' D
Construction Authorization Expiration Date: 0
S 3
HTE# S "~3i Permit # ~5~-o
Harnett ('onntyT Dept,tAment of Public Health
Site 'k-' ketch
PROPERTY LOCATON: /
ISSUED TO: I1 C ~ SUBDIVISION CAM ~ rtr~ LOT #
Authorized State Agent: 4 Dater 0
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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: a
Applicant:
Address:
Date Evaluated:
Proposed Facility: S__ Design Flow (.1949):3„
Property Size:
Location of Site: l [ r
Property Recorded:
Water Supply: Public [ I Individual [ ] Well
[ ] Spring (j Other
Evaluation Method: Auger Boring [ j Pit
(j Cut
Type of Wastewater. -/Sewage O Industrial Process
[ ] Mixed
P
R
0
F
SOIL MORPHOLOGY
1941
OTHER
PROFILE FACTORS
`
1
L
E
#
.1940
Landscape
Position/
Slope%
Horizon
Depth
(IN.)
1941
Structure/
Texture
.1941
Consistence
Mineralogy
.1942
Soil
Wetness/
Color
.1943
Soil
Depth (IN.)
.1956
Sapro
Class
1944
Restr
Horiz
Prone
Clan '
& 4TAR,
IN,
f
Description
Initial System
Repair System
Available Space (.1945)
,System Type(s)
Site LTAR
t
Other Factors (.1946):
Site Classification (.1948): Q/
Evaluated By:~
Others Present: