IPACHTE#-O` )i -5-' ~)~-S- Harnett County Department of Public Health 25321
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: !EvCSW1 N 1;_10
ISSUED TO: a55 C~ - ~LZ ~1 ~ <2S SUBDIVISION Gq-p, v G~E_ LOT # _ G}
NEW)% REPAIR ❑ EJANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure:
Proposed Wastewater System Type: L
Projected Daily Flow: 0 GPD
Number of bedrooms: Number of Occupants: max
Basement ❑Yes X No
Pump Required: ❑Yes ❑ No 'X May 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 Agent:: ' ~ Date_ 0 -111 n SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the issuance o other permits. The permit holder is r ponsible for checking with appropriate governing bodies in meeting their requirements. This
site is subject to revocation if the site plan, pla( 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: nc)s-:~ ~"OcnG Q o►ZL,oc-QS PROPERTY LOCATION: 'V6tZr,
SUBDIVISION ~2~ ~tioE s~i~s LOT #
Facility Type: New ❑ Expansion ❑ Repair
Basement? ❑ Yes, No Basement Fixtures? ❑ Yes No
Type of Wastewater System** (Initial) Wastewater Flow: 7'~0 GPD
(See note below, if applicable
C 0 4 ~0 p~> (Repair)
Installation Requirements/Conditions Number of trenches
Septic Tank Size 1 0 C)0 gallons Exact length of each trench ~C) feet Trench Spacing: feet on Center
Pump Tank Sae gallons Trenches shall be installed on contour at a Soil Cover: Y4- inches
Maximum Trench Depth of: 20-1-1 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
Conditions:
inches below pipe
Aggregate Depth: inches above pipe
inches total
**If applicable: / anderrtand the ryrtem type specified it different from the type specified on the application. / accept the rpec16c20onr of thin permit.
Owner/Legal Representative Signature: Date:
-J iu uuv n me site is or me mtenaea use changes, the lonstruction Authorization shall not be transferred when there is a change in ownership of the site. This
Construction Authorization «to complian! ith t o s e laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
ig Authorized State Agent: Date: coq
Constr 'on Authorization Expiration Date: 6 1
HTE# Permit It 4-
ISSUED T0: mo~
Authorized State Agent:
Harnett County- Department of ll~tblic Health
Site Sketch
PROPERTY LOCATON:~u
~lncn v DE-Q-S SUBDIVISION GQ. -)IY QLOT # _
Date: I h~d
ueparllltem ul CI Iv11UI1111Cm, MWdIM, d11U IvdlUldl rlt'JUUIt tlJ
Division of Environmental Health
On-site Wastewater Section
SOILiSITE EVALUATION
for ON-SITE WASTEWATER SYSTEM
Owner:
Address:
Proposed Facility: 3 ~ m hroeh~ Design Flow (.1949): 3L0 ~
Location of Site:
JI letlk.
Property ID:
Lot
File
Code:
Applicant:
Water Supply: ' 'Public (j Individual (j Well
Evaluation Method: ~VT'Auger Boring [ J Pit
Type of Wastewater: / Sewage industrial Process
Date Evaluated:
Property Size:
Property Recorded:
[ j Spring (j Other
[ ] Cut
( I Mixed
P
R
O
F
SOIL MORPHOLOGY
.1941
OTHER
PROFILE FACTORS
1
L
E
.1940
Landscape
Position/
Slope%
Horizon
Depth
IN.)
.1941
Structure/
Texture
.1941
Consistence
Mineralogy
.1942 ,
Soi
Wetnew
Color
.1943
SoN
Depth IN.)
.1936
Sapra
Class
.1944`
Rests
Horiz
Profile
Class
& LTAR
(7, s L
e5l
o -u
s c~
Cr
vin r ~P
Description
Initial ystem
Re air System
Available Space (.1945)
V
t/
System Type(s)
CXJ N
~0 t\j
Site LTAR
S
S_ I
Other Factors (.1946): _
Site Classification (.1948p):1 15
Evaluated By:(7
Others Present: -