IPACHTE# 0`7 -s ~aosg Harnett County Department of Public Health 2 5 2 9 2
Improvement Permit
A building permit cannot be issued with only an Im rovement Pe j
c-~ PROPERTY LOCATION: S~ I l 1'r cs
ISSUED T0: -c)
r`c 5, y der SUBDIVISION LOT #
NEW I7 REPAIR . EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: M L/
Proposed Wastewater System T pe: v"" Jc.r` • ax
Projected Daily Flow: d GPD
Number of bedrooms: Number of Occupants: max
Basement ❑Yes Z'-No
Pump Required: ❑Yes ❑ No ER
May be required bao on final location and elevations of facilities
Type of Water Supply: El Community ❑ Public EP Well Distance from well d~ feet Permit valid for li f<ve years
Permit conditions: ❑ No expiration
Authorized State Agent:: / `.j c>`- ~e- f Date: !tom tad 9 SEE ATTACHED SITE SKETCH
The issuance of this permit by Health 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 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 .19SO, .1952, .1954, .1955, .1956, .1957, .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: , Er-+4- k- S;y d er PROPERTY LOCATION: _5-1- 2Y
SUBDIVISION
Facility Type: c-F'D f New ❑ Expansion
Basement? ❑ Yes 1~6o Basement Fixtures? El Yes ❑ No
Type of Wastewater System C-. a tiy I A4-'. t~
(See note below, if applicable
❑ Repair
C0.'Jc., ~ "0.1 (Repair)
Installation Requirements/Conditions Number of trenches
Septic Tank Size AM gallons Exact length of each trench /00 feet
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of: / E) inches
(Trench bottoms shall be level to +/-1/4"
LOT #
(Initial) Wastewater Flow: y80 GPD
Trench Spacing: Feet on Center
Soil (over: inches r*o^
(Maximum soil cover shall not exceed
36" above the trench bottom)
in all directions)
Pump Requirements: ft. TDH vs. GPM inches below pipe
pp _ Aggregate Depth: _i_ inches above pipe
Conditions: di- k a• n ~..cf- c~ ~a+t inches total
**If applicable: /understand the system type specified it different from the type specified on the app/i 36fl. / accept the specifications of this permit.
Owner/Legal Representative Signature: Date:
VII-L-11 I-1-Ld-11 D WVItLt w revoianua a me site plan, piac or me mtenaeo use changes. Me tonstrucron Authorization shall not be transferred when there is a change in ownership 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 Agent: . }3 k.1- Date: c- C Q ~
Construction Authorization Expiration Date: fir/ /.20/'/
HTE# U ~-5- ~'3,`s F-r Permit # Z rd-9 2
Harnett Connty Department of 1""ablic Health
Site Sketch
s- PROPERTY LOCATON:
ISSUED TO: J ~i1~ ~y deg- SUBDIVISION LOT #
Authorized State Agent: /Vcj . Date: '7 2 oa S
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Division of Environmental Health
On-site Wastewater Section
SOIUSITE EVALUATION
for Off-SITE WASTEWATER SYSTEM[
Owner:
Address:
Proposed Facility:
Location of Site:
Water Supply:
Evaluation Method:
Type of Wastewater:
Design Flow (.1949):
( I Public Individual
[4A ger Boring
[.-)'Sewage
-at C"t.
Property ID:
Lot
File
Code:
Applicant:
Date Evaluated.
Property Size:
Property Recorded:
[ Well [ 1 Spring Other
Pit Cut
(j industrial Process Mixed
P
R
O
F
SOIL MORPHOLOGY
.119411
OTHER
PROFILE FACTORS
1
L
E
6
.1940
Landscape
Position/
S"%
Horizon
Depth
IN.)
.1941
Structure/
Texture
.1941
Consistence
Minerafty
.1942 .
Son/
Wetness/'
Color
1943
Sol
Depth IN.)
1936
Sal;M
Class
.19"
f Rests
Horiz
Profile ,
Class
a LTAR
C -a(~,
G Is
/T
do-~70
f9k Sal
~r ~~f~
6
WJA_1,-1
-X,
57~
Y IL T
L
Description
Initial System
Repair System
Available Space (.1945)
System Type(s)
C
C "
1q1tA LTAR
- ~I
Other Factors (.1946):
Site Classification (.1948): r2J
Evaluated By:,~),%-.
Others Present: