IPACHTE# CIP ~ Harnett County Department of Public Health 2 5 5 6 7
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: C~ k so K Na CsZ L--I~J
ISSUED T0:6t A~ C ~f M cr sh1 65 SUBDIVISION LOT # _
NEW REPAIR ❑ EXPANSION ❑
Type of Structure: 5~ nr, a )
Proposed Wastewater System Type: C. rv E hs c, t y o 1_
Projected Daily Flow: ' 6 C GPD
Number of bedrooms: _~_75 Number of Occupants: C, max
Basement ❑Yes No
Site Improvements required prior to Construction Authorization Issuance:
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 1 feet Permit valid for Five years
Permit conditions: ❑ No expiration
Authorized State Agent: 5 Date: 7 SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the issuance o o rmits. 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 I 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 TO: ~)n.•PiD wmcri~Fv GS
Facility Type: SFO X New
Basement? ❑ Yes X, No Basement Fixtures? ❑ Yes
Type of Wastewater System'" t"J Q" L_
(See note below, if applicable
PROPERTY LOCATION: >w: o s ~~b ina 1
SUBDIVISION LOT # N
❑ Expansion ❑ Repair
XI No
CIO C4 -'r sS-~b N P" .y (Repair)
Installation Requirements/Conditions Number of trenches Q.
Septic Tank Size V O(ZNO gallons Exact length of each trench s C~ feet
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of: 9-Zl -3 inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
Pump Requirements: ft. TDH vs. GPM
Conditions:
(Initial) Wastewater Flow: ~,CS GPD
Trench Spacing: Feet on Center
Soil Cover: to-aL) inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
Aggregate Depth:
inches below pipe
Z inches above pipe
inches total
**If applicable: / understand the system type specified is different from the type specified on the app/icatian. / accept the rpecifications of this permit.
Owner/Legal Representative Signature: Date:
This Construction Authorization is subject to rev hte p lat 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 i o compliance wi to pr f th ws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent: Date:
Constr on Authorization Expiration Date:
HTE# C1-S--~ ~u Permit # X541
Harnett County Department of Public Health
Site ketch
PROPERTY LOCATON: Q`t0n;oi 0~2 t~
ISSUED T0: a r SUBDIVISION LOT
Authorized State Agent:
kl~c .
Date: `►0 ~N
~C~
ueparumtem ul c11V11U11111C111, r1Cd1111, d11U I4dlU1d111CDUUJLttb 0IIGt1k.
Division of Environmental Health Property ID:
On-site Wastewater Section Lot
File
SOILiSITE EVALUATION Code:
for ON-SITE WASTEWATER SYSTEM
Owner:
Applicant:
Address:
Date Evaluated:
QC d~~
Proposed Facility: -Design Flow(. 1949):
Property Size:
Location of Site:
Property Recorded:
Water Supply:
Public Individual
(J Well
[ ] Spring
Evaluation Method:
Auger Boring
[ J Pit
[ j Cut
Type of Wastewater.
ewage
[ j Industrial Process
(j Mixed
[ I Other
P
R
o
F
SOIL MORPHOLOGY
.1941
OTHER
PROFILE FACTORS
1
L
E
#
.1940
Landscape
Position/
Slope%
Horizon
Depth
IN.)
.1941
Shwtwet
Texture
.1941
Consistence
Miners
logy
.1942 .
SoN
Wetness/'
Color
.1943
Soll
Depth IN.)
.1986
Sapm
Class
.19"
Restr
Hodz
Profile
,
Class
3 LTAR
-a~l
~I
0 3~
L5
1,w
P 5
~
c
o
-
53
~N
5
.
P5
S9,1 'SL-1-
Description
Initial 'ystem
Repair System
Available Space (.1945)
System Type(s)
Site LTAR
5
SS
Other Factors 1946): _
Site Classification (.1948):
Evaluated By:
Others Present:
1j_:n