IPACHTE# O" ~ Harnett County Department of Public Health 2 5 5 5 2
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: L_Eroyt=.L. SLC,chc. Q4
ISSUED T0: C oN~s2v~~v25 lrv C, SUBDIVISION Foa c>s-~ Oo. PsQ LOT # 111
NEW REPAIR I] XPANSION El Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: Sc O I4"z`1AK15
Proposed Wastewater System Type: Co N v E. r 10 N K\,
Projected Daily Flow: 3~d GPD
Number of bedrooms: Number of Occupants: max
Basement ❑Yes -?I 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 E00 feet
Permit conditions: 7!~-
Authorized State Agent:: IQ..&
The issuance of this permit by the Health Department in no way guarantees the issua
site is subject to revocation if the site plan, plat, or the intended use changes. The Impr
the Laws and Rules for Sewage Treatment and Disposal and to conditions of this permit..
Permit valid for.
Date: 11-7 C Oq SEE ATTACHED SITE SKETCH
other permits. The permit holder is responsible for checking with appropriate governing bodies in meeting their requirements. This
tent Permit shall not be affected by a change in ownership of the site. This permit is subject to compliance with the provisions of
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: NXN ~NQ~c-svaS PROPERTY LOCATION:
SUBDIVISION Fo y 0--'rA $sj3 LOT # _7
Facility Type: 5~0 ('i ~n3~ 7 New ❑ Expansion ❑ Repair
Basement? ❑ Yes 'K No Basement Fixtures? ❑ Yes 'X No
Type of Wastewater System**
~ "'X-Ms rs C r+ 0.,L-
(See note below, if applicable
C-o c+ vsrsGX C--s n►?•►~ (Repair)
Installation Requirements/Conditions Number of trenches L
Septic Tank Size t oca
gallons Exact length of each trench 1
Pump Tank Size
gallons Trenches shali be installed on contour at a
Maximum Trench Depth of. N%-,50
(Trench bottoms shall be level to +/-1/4"
in all directions)
Pump Requirements:
ft. TDH vs. GPM
Conditions:
(Initial) Wastewater Flow: 36e0 GPD
feet Trench Spacing: c1 Feet on Center
Soil Cover. -1~ inches
inches (Maximum soil cover shall not exceed
36" above the trench bottom)
inches below pipe
Aggregate Depth: inches above pipe
S - inches total
**If applicable: /understand the system type specified is different from the type specified on the app/ication. I accept the specifications o/ thin permit.
Owner/Legal Representative Signature: Date:
This Construction Authorization is subject to revoc the Ian, 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 suQ~Mccomplianc s Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Five years
❑ No expiration
Authorized State Agent: Q-3 Date: `z C~r►
Construc 'on Authorization Expiration Date: -11
HTE# Oc-~ Permit #SS~
Harnett County Department of Flablic Health
Site Sketch
PROPERTY LOCATON: t-*-M vEt_ $L
ISSUED TO: ~A- )iA vex 2s ~N L SUBDIVISION LOT # ~
Authorized State Agent: Q-s t-Y o LYSO OQS= Date: `7
I ENV&ni,
2EPq~Q,
i ~LLr O [-.S
P A-c ~ 0
a. 36,
i~
C
~A5X6c-5 vA~ LJ~.~v[
)epartment or environment, r1eaitn, ano rvaturai mesuuices
)ivision of Environmental Health Property ID:~
)n-site Wastewater Section Lot
File
SOIL/SITE EVALUATION Code:
for ON-SITE WASTEWATER SYSTEM
Owner: Applicant:
Address: Date Evaluated:
Imposed Facilitv:3 $epe.Zejr~ lAo+~T~ Design Flow (.1949):340q Property Size:
.ocation of Site: J Property Recorded:
Vater Supply: Public (j Individual [ j Well [ J Spring [ ] Other
:valuation Method: Auger Boring Pit [ J Cut
ype of Wastewater: Sewage [ ]Industrial Process (J Mixed
P.
R
o
F'
SOIL MORPHOLOGY
t941`:
- `OTHER
PROFILE FACTORS
1
Li
E'
1940
Landscape
Position(,
Slope%'
Horizon
Depth
(IN.)
.1941 f
Structure/
Texture
1941
Consistence :
Miriera{ogy
:1942:,.
Soil
Wetnessl-:"
Color
1943
SOIL
Depth ({N.)
1956
Sapro
Class
.1944
Restr
Hariz
Profile,
Class
8 LIAR -
t
L)5
a
G S
V Fri, N35 'V~)
S 4
z
-ti2~
G S
~(Fn. NS N~
S g
Description
Initial stem
Repair System
Available Space (.1945)
System Type(s)
G cf N
N
Site Site LTAR
' Z
'
Other Factors (.1946): _
Site Classification (.1948):
Evaluated By: (37~
Others Present: