IPACHTE#0°1 -5- a-)341 Harnett County Department of Public Health 2 5 3 5 0
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: L-Sr\V&L- e2o
ISSUED TO: C-0 N%Q,Vc-10(S IN C. SUBDIVISION V~~6srs Oo,~~ P,~3 LOT # 135
NEW REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: SFO t3°s x,
Proposed Wastewater System Type: Cqw v ej-r-4s CJ N p. L_
Projected Daily Flow: ~L GPD
Number of bedrooms: 3 Number of Occupants: max
Basement ❑Yes 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 Id0 feet
Permit conditions: C'-
Authorized State Agent::
The issuance of this permit by the Health Department in no way guarantees the iss
site is subject to revocation 4 the site plan, plat, or the intended use changes. The Imps
the Laws and Rules for Sewage Treatment and Disposal and to conditions of this permit.
Date: `7 * SEE ATTACHED SITE SKETCH
of other permits. The permit holde is responsible for checking with appropriate governing bodies in meeting their requirements. This
vtrtnt 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 TO: " r A C cr>„5~(LVC ~CIQa~ G PROPERTY LOCATION: 1-F1"`ive-t, g ia,c,K (2D
SUBDIVISION O p.KS Yp3 LOT # \_55
Facility Type: `7 C0 3''~ '~S G J New ❑ Expansion ❑ Repair
Basement? ❑ Yes No Basement Fixtures? ❑ Yes VI.No
Type of Wastewater System** Co N vr_,SV\ U N 9.'L- (Initial) Wastewater Flow: 34-0 GPD
(See note below, if applicable
C.a Nvrw-S 0 N A L- (Repair)
Installation Requirements/Conditions Number of trenches f
Septic Tank Size t CNn d gallons Exact length of each trench Isd
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of: Y4 -30
(Trench bottoms shall be level to +/-1/4"
in all directions)
Pump Requirements: ft. TDH vs. GPM
Conditions:
Aggregate Depth:
inches below pipe
inches above pipe
1 inches total
**If applicable: /understand the fyrtem type rpeci~ed is different from the type rpecied an the app/icatiQn. / accept the rpecificationr of thir permit.
Owner/Legal Representative Signature: Date:
-.1", - aeon it we site n, pias, or me mrenaeo use cnanges. ine tonstrucnon sutnonzation shall not be transferred when there is a change in ownership of the site. This
Construction Authorization isct,ompliance to i of ws and Rules for Sewage Treatment and Disposal and to the conditions of this permit. SEE ATTACHED SITE SKETCH
Permit valid for:
X five years
❑ No expiration
feet Trench Spacing: Feet on (enter
Soil Cover: G -4 N1 inches
inches (Maximum soil cover shall not exceed
36" above the trench bottom)
Authorized State Agent: Date: -)o
Construct) uthorization Expiration Date: -t
HTE# O":-"' -5 Permit # ~53S0
Harnett County Department of Public Health
Site Sketch
PROPERTY LOCATON: - v6L gLA<,,(- 4
ISSUED T0: a ~.uHs ;a v~~ c ~^►G SUBDIVISION 'FOcLP-" 0a u-3 LOT # 135
Authorized State Agent: Date: --I 1-71(5`{
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Department of Environment, Health, and Natural Resources Sheet:
Division of Environmental Health Property ID-
On-site Wastewater Section Lot
File
SOIL/SITE EVALUATION Code:
for ON-SITE WASTEWATER SYSTEM
Owner: Applicant:
Address: Date Evaluated:
Proposed Facility: 3 BFAgw." AomL Design Flow (.1949):3(,0 ayo Property Size:
Location of Site: Property Recorded:
Water Supply: ublic individual [ ] Well [ ] Spring
Evaluation Method: uger Boring [ ] Pit [ ] Cut
Type of Wastewater. Sewage [ ] industrial Process [ J Mixed
[ ] Other
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.
Soil
Wetness/
Color
.1943
Soil
Depth (IN.)
..1956
Sapro
Class
.1944
Restr
Horiz
Profile
Class
& LTAR
i
-~~i
~ ~
vin. ~s 1~ ~
~ ••d
Description
Initial System
epair System
Available Space (.1945)
V/
I
System Type(s)
fit-/
Gd3-i
Site LTAR
Other Factors (.1946):
Site Classification (.1948):
Evaluated By:
Others Present: