IPACHTE# Q)n-54Z~5wg Harnett County Department of Public Health 2 5 5 7 5
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: N v~ s~ q_p
ISSUED TO: C Pwtit SUBDIVISION LOT #
NEW; REPAIR ❑ ►ai EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure:
Proposed Wastewater System Type: C.crtvv~y ~ct~P L
Projected Daily Flow: "'ado GPD
Number of bedrooms: 3 Number of Occupants: max
Basement ❑Yes )~Z No
Pump Required: ❑Yes ❑ No (May be required based on final location and elevations of facilities
Y
Type of Water Supply: 11 Community Public ❑ Well Distance from well V'-)0
feet Permit valid for: Five years
Permit conditions: ❑ No expiration
Authorized State Agent::
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.
Date: 8 SEE ATTACHED SITE SKETCH
permits. The permit holder is responsible for checking with appropriate governing bodies in meeting their requirements. This
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 J950, .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: C(,-,-4 t'~~S ~Np 'Ue~F en~_- Ns , PROPERTY LOCATION: ~yrt LY RSj
L.~N SUBDIVISION Foci
Facility Type: s'~70('X New ❑ Expansion ❑ Repair
O A~~ LOT # ) `3 3
Basement? ❑ Yes - No Basement Fixtures? ❑ Yes 'XI No
Type of Wastewater System**
(Initial) Wastewater Flow: 3 d GPD
(See note below, if applicable
co~r~lE ``f•;`nc~p,c-- (Repair)
Installation Requirements/Conditions Number of trenches
Septic Tank Size 1, c7o c } gallons Exact length of each trench f S 0 feet
Trench Spacing: ` Feet on Center
Pump Tank Size gallons Trenches shall be installed on contour at a
Soil Cover inches
Maximum Trench Depth of: N -3 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: ~ , -o Yt...ume~" s ~l~At~ o°~ r ~cL cr C' ~1Ry 6~ C O I
a inches total
**If applicable: / undeatand the ryrtem type specified is different from the type ,rpeci6ed on the app/icatian. / accept the rpecificationr of thin permit.
Owner/Legal Representative Signature: Date:
-It 111-g- lift lumuuwon numunraaon snail not oe transterrea wren there is a change in ownership of the site. This
Construction Authorization is su (compliance with e proms t ws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent: Date: ~F 3
Construct) uthorization Expiration Date: _
HTE# Permit #
Harnett Connty Department of 11~ blic Health
Site Sketch
PROPERTY LOCATON: ~a ECG
ISSUED T0: C.Q~ «i I_A ~E~ -uyZ SUBDIVISION ~c,t~GsS O~~s LOT #
Authorized State Agent: Date: 13 8
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Property ID:
)Ivision of Environmental Health
Lot #
On-site Wastewater Section
File
SOIL SITE EVALUATION Code:
for ON-SITE WASTEWATER SYSTEM
Applicant:
Owner:
Date Evaluated:
Address:
Desi Flow (.1949): R (3 Property Size:
Proposed Facility: ~yclezr~ ~u ,C
Property Recorded:
Location of Site:
Public [)Individual Well I) Spring [)Other
Water Supply:
Evaluation Method: JA uger Boring (j Pit (j cut
[ J Industrial Process [ I Mixed
Type of Wastewater. ~ewage
P
R
SOIL MORPHOLOGY
OTHER
o
PROFILE FACTO
RS
.1941
F
1942
I
1940
1841
.
Soil
.1943
i 9~
.194
pmalle ,
L
E
L
P osltbN
Horizon 000
Dspflt
.1941 Sbucturs/
.
Consistence
Weblew
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D
th
Ssp O
Class
~ Re*
Notlz
Class
a LTAR
S %
IN.
Texture
mkmnlogy
Cow
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ep
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Description
Initial System
epalr System
Available Space (.1945)
S stom T pe(s)
G~
cc) N
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l~
.S
Other Factors (.1946):
Site Classification (.1948):
Evaluated By:
l ik- Drnconl-