IPAC RHTE# OqHarnett County Department of Public Health 2 5 5 7 a
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: M0,, YS VP
ISSUED TO: S`w~ar~~tL.--4, ~e~,2 ~~-~OhJ SUBDIVISION LOT #
NEW-X REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: SF S7 ~~,z,~~,0~
Proposed Wastewater System Type: aS°!~OUGS,pt.t Syy,h
Projected Daily Flow: 3 GPD
Number of bedrooms: 3 Number of Occupants: max
Basement ❑Yes No
Pump Required: ❑Yes ❑ No ~KMay be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community Public ❑ Well Distance from well IC~-') feet} Permit valid for. Five years
Permit conditions: ❑ No expiration
Authorized State Agent:: Date: `1T_~bq SEE ATTACHED SITE SKETCH
The issuance of this permit by the 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 .1950, .1952, .1954, .195S, .1956, .1957, .1956. 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:~..r ~2~c~ CoayrL~ri Sot J PROPERTY LOCATION: M~
SUBDIVISION _ psti~~D2n LOT #
Facility Type: SF S7 x ~O'~ X New ❑ Expansion ❑ Repair
Basement? ❑ Yes X No Basement Fixtures? ❑ Yes XNo
Type of Wastewater System's* RLJ~ C<\-" S`l~' (Initial) Wastewater Flow: 3feo GPD
(See note below, if applicable
YPgQS Mnwk G0~(Repair)
Installation Requirements/Conditions Number of trenches I
Septic Tank Size loon gallons Exact length of each trench ~.b0 feet Trench Spacing:_ Feet on Center
Pump Tank Size gallons Trenches shali be installed on contour at a Soil Cover: inches
Maximum Trench Depth of: 1-,2 inches (Maximum soil cover shall not exceed
(Trench bottoms shall be level to +/-1/4" 36" above the trench bottom)
in all directions)
Pump Requirements: ft. TDH vs. GPM inches below pipe
Aggregate Depth: inches above pipe
Conditions: " ~►-t sp a r, C C9 cv }~ru,~v g fit, rt t p~ L,\ CIer WTI's inches total
5a,r_ 5c.rc-,S %~s- .
"If applicable: /understand the system type specified is different from the type specified on the app/ication. / accept the specifications of thlr permit,
Owner/Legal Representative I Date:
This Construction Authorization is subject to rev ion I t o la 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 is s Qmpliance wit pr o ws and Rules for Sewage Treatment and Disposal and to the conditions of this permit. SEE ATTACHED SITE SKETCH
Authorized State Agent: 0''~ M ~ fLS Date:
Authorization Expiration Date:
HTE# C°►` S Permit # `a.5"1 O
Harnett County Department of ll~tblic Health
Situ Sketch
ISSUED TO: -yp,t.o-
Authorized State Agent:
PROPERTY LOCATON:tuc~S Qv
SUBDIVISION "~.t*fw-cgm } LOT # _
ou v E z-s'ayUoOS Date: ~7T t I~4q
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Division of Environmental Health
On-site Wastewater Section
SOIUSITE EVALUATION
for ON-SITE WASTEWATER SYSTEM
Owner:
Address:
Proposed Facility:
Location of Site:
Water Supply:
Evaluation Method:
Type of Wastewater:
Design Flow (.1949):
[ ) Public [ j Individual
( j Auger Boring
[ j Sewage
Jt letft. . .
Property ID:
Lot
File
Code:
Applicant:
Date Evaluated:
Property Size:
Property Recorded:
[ j Well Spring (j Other
[ ] Pit Cut
Industrial Process Mixed
P
R
o
F
SOIL MORPHOLOGY
.1941
OTHER
PROFILE FACTORS
1
L
E
0
.1940
Landscape
Position/
SI %
Horizon
Depth
IN.
.1941
Structure!
Texture
.1941
Consistence
Mineralogy
.1942
Soil
Wetnow
Color
.1943
SON
Depth INJ
.05111
Saps
Class
; .1944
t Re*
Horiz
Profile ;
Class
& LTAR
t
0-0"Ira~l,
FI1_I- a
~ xC$,,~,,~wE
V~
t~
a~tlt?
t
5
t s l '
t04at.-7)a.
wl M1
UJ,
Description Initial System Repair System
Available Space (.1945)
System Type(s)
Site LTAR
Other Factors (.1946):
Site Classification (.1948):
Evaluated By:
Others Present: