IPACFITE# 0 9 -,5-- Z2, ys' Harnett County Department of Public Health 25281
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
C PROPERTY LOCATION: 5_2 0,90 Cr c a ~arn K~.
ISSUED TO- f~ a ~„pV r" s CQ SUBDIVISION LOT #
NEW Z REPAIR ❑ , EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: 8 `6 d`
Proposed Wastewater System Type: C~c 4k(/`1^ "0M
Projected Daily Flow: , 3 4 GPD
Number of bedrooms: J Number of Occupants: max
Basement I❑Yes No -
Pump Required: ❑Yes ❑ No LTJ May be required bad on final location and elevations of facilities
Type of Water Supply: ❑ Community ❑ Public LS Well Distance from well d~ feet Permit valid for. ~Kive years
Permit conditions: ❑ No expiration
Authorized State Agent:: ~f 1~ttro._ ~ .f Date: ~ /2-96a00 9 SEE ATTACHED SITE SKETCH
The issuance of this permit by t~e h 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 4 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, AM, .1954, 1955, .1956, .19S7, .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: ~o d ~1 cr-;J-C t PROPERTY LOCATION: ,5.Z A 9 0
SUBDIVISION
Facility Type: ZNew ❑ Expansion ❑ Repair
Basement? ❑ Yes No Basement Fixtur s? ❑ Yes ❑ No
Type of Wastewater System" CCSaV.1AT,V ~1~k (Initial) Wastewater Flow:
(See note below, if applicable
C0&if~' "4--o-'_._V' (Repair)
Installation Requirements/Conditions Number of trenches ,3
Septic Tank Size pq Q gallons Exact length of each trench /jr feet
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of. /02" inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
Pump Requirements: lft. TDtH vs. GPM
Conditions: Wit ~c~e5 - m tic kilviliQ
L;,V'e Q+ Ci vl' M. v S
t
LOT #
15(10 GPD
Trench Spacing: ? Feet on Center
Soil Cover: 6 - 1.2 inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
Aggregate Depth:
C inches below pipe
inches above pipe
inches total
12v0~. C Q cj k cs
I "*If applicable: /understand the system type specified /s different from the type specified on the application. / accept the specifications of this permit.
Owner/Legal Representative Signature: Date:
This Construction Authorization is subject to revocation if the site plan, plat, or the intended use changes. The Construction Authorization shall not be transferred when there is a change in
of the site. This
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 Agen 14~ 1~1_ TIC-7, Date: •Z a 9
Construction Authorization Expiration Date: b of 4 ,2 ,0
HTE# p ~ - s-- 2. 21(4 S' Permit It J oZ ~F- /
Harnett County; Department of Public Hearn,
Site Sketch
PROPERTY LOCATON: S2 C Grc_ i~c~ M
ISSUED TO: o~ c f S- S9 SUBDIVISION LOT #
Authorized State Agent: w c Date: 2- q 1.2 g
,Qr~a
1
,,J. 4- 4, r ( It
U
f
Division of Environmental Health
On-site Wastewater Section'
SOIL/SITE EVALUATION
for ON-SITE WASTEWATER SYSTEM
Owner:
Address:
Proposed Facility:
Location of Site:
Water Supply:
Evaluation Method:
Type of Wastewater:
Design Flow (.1949):
[ J Public [ j Individual
[ J Auger Boring
[ j Sewage
Property ID:
Lot
File
Code:
Applicant:
[Well
[ ] Pit
( J Industrial Process
Date Evaluated:
Property Size:
Property Recorded:
( j Spring
[ ] Cut
Mixed
[ J Other
P
R
SOIL
MORPHOLOGY
OTHER
F
.1941
PROFILE= FACTORS
L
E
1940
Landscape
Position/
Horizon
Depth
.1941
Structurei'
X1941
Consistence
.1942
SOi[ Fft1943-' ~.i956
W
tr
l
a
f t
` 1g4# proliilaµyt
Slope96
IN.
Texture
-
Mineral'
e
tesa
Color
t SoN,~ { Sa pro
De INJ Class
i Rte; , Class
f Horiz LTM h
Z-5
~ A/r
V A-
.5.S fj?
f I
3~ `
f4)
y. c
0 - if
- Lj
G-
Uf~- fv1~vllo
nn
G ~
LI,
rrJN~
2"ll-L r/1c~
Er -j am
Description
Initial System
Repair System
Available Space (.1945)
System Type(s)
U
u ✓
Site LTAR
t
Other Factors (1946)
Site Classification (.1948):
i
Evaluated By:
Others Present: