IPACHTE# oa s-aaa~~ Harnett County Department of Public Health 2 5 3 2 6
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: 0
ISSUED TO: wrr_osy rc62~ ~E~161 o2c SUBDIVISION Q~5 ~`1c C n Qua p, LOT # X)
NEWWX REPAIR ❑ +RANSION El Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: 5GS) Q -1c) 5~
Proposed Wastewater System Type: t ~r.rv E rC~O r~i 011-
Projected Daily Flow: 4S 0 GPD
Number of bedrooms: Number of Occupants: `b max
Basement ❑Yes No
Pump Required: ❑Yes No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community Public ❑ Well Distance from well tbd feet Permit valid for 'Five years
Permit conditions: _ ❑ No expiration
Authorized State Agent.: Q~S Date: Q I ~ b9 SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the rs ce 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 T0: PROPERTY LOCATION: 0) 110 a~
SUBDIVISION R~~S 't" 1~P,& ~!LV-AC-_ LOT # _2
Facility Type: New ❑ Expansion ❑ Repair
Basement? ❑ Yes `~R No Basement Fixtures? ❑ Yes No
Type of Wastewater System' Co 6 1 a r.r o1- (Initial) Wastewater Flow: .49C)_ GPD
(See note below, if applicable
C..o'r.ryE-'s'C\osy opt- (Repair)
Installation Requirements/Conditions Number of trenches a
Septic Tank Size 1 b (50 gallons
Pump Tank Size gallons
Pump Requirements: ft. TDH vs.
Conditions:
Exact length of each trench ~oCO
Trenches shall be installed on contour at a
Maximum Trench Depth of: ate}
(Trench bottoms shall be level to +/-1/4"
in all directions)
GPM
inches below pipe
Aggregate Depth: inches above pipe
inches total
**If applicable: / understand the system type specired is different from the type specired on the application. / accept the specifications of thin permit
Owner/Legal Representative Signature: Date:
This Construction Authorization is subjec~to don if th ite plan, plat, or the intended use changes. The Construction Authorization shall not be transferred when there is a change in ownership of the site. This
Construction Authorization is subje to w ns of the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent:
?`i5 Date: C
feet Trench Spacing: Feet on Center
Soil Cover. 1a inches
inches (Maximum soil cover shall not exceed
36" above the trench bottom)
ction Authorization Expiration Date:
HTE# Permit # a53
Harnett County Department of 1'ablic Health
Site Sketclh.
PROPERTY LOCATON: O,0 4~,,1
ISSUED TO: uE~~ DEv Pc SUBDIVISION lp~S LOT # a
Authorized State Agent QS `0~~~~0~-Y~OO Date: aq
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Division of Environmental Health Property ID:
On-site Wastewater Section Lot
File
SOIUSITE EVALUATION Code:
for ON-SITE WASTEWATER SYSTEM
Owner:
Applicant:
Address:
Date Evaluated:
Proposed Facility: ~ $ (VZ(01, hcrt
Design Flow(. 1949): '
Property Size:
Location of Site:
Property Recorded:
Water Supply:
Public
( j Individual [ j Well
(J Spring
Evaluation Method:
Auger Boring
(j Pit
[ i Cut
Type of Wastewater:
Sewage
[ J Industrial Process
(J Mixed
[ j Other
P
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F
SOIL MORPHOLOGY
.1941
OTHER
PROFILE FACTORS
1
L
E
0
.1940
Landscape
Posit n/
SI 9L
Horizon
Depth
(IN.)
.1941
Shicturs/
I Texture
.1941
Consistenos
Mrwra
1942 .
Sol
WebtaW
Color
.1943
Sol
Depth IN.)
.19;10
Sepra
Class
.1944
f Re*
Horb:
Proflie ,
Class
a LTAR
L5
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7
1010,
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C -5
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7
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Description
Initial System
Repair System
Available Space (.1945)
`
System Type(s)
ca
Site LTAR
Other Factors (.1946): _
Site Classification (.1048): ~7 ~C l
Evaluated By: \
Others Present: