IPAC RHTE# Harnett County Department of Public Health 2 5 5 7 6
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: H w y 1'~!
ISSUED T0:SL~cK SUBDIVISION oI i--, L LOT #
NEW REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: S~J ( "(6 xIyO
Proposed Wastewater System Type: V0 -9 -~Q aS o u C~~ c}t l
Projected Daily Flow: 36b GPD
Number of bedrooms: 3 Number of Occupants: max
Basement ❑Yes XNo
Pump Required:-Oyes ❑ No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community Public ❑ Well Distance from well ),00 feet Permit valid for. Five years
Permit conditions: ❑ No expiration
Authorized State Agent.: Date: b~ SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the issuanc er 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 ermit shall not be affected by a change in ownership of the site. This permit is subject to compliance with the provisions of
the Caws 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, .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:~~ PROPERTY LOCATION:
SUBDIVISION LOT
Facility Type: SCO ~~b~'~~15~~ New ❑ Expansion ❑ Repair
Basement? ❑ Yes No Basement Fixtures? ❑ Yes n No
Type of Wastewater System** uf-9, '\o r3-=~/o OV 's (Initial) Wastewater Flow: GPD
(See note below, if applicable
~u MP ~4 ~~'/O RF--cu CLOI3 (Repair)
Installation Requirements/Conditions Number of trenches 1
Septic Tank Size \0 ad gallons Exact length of each trench 11) C 1 feet
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of: I,`Z inches
(Trench bottoms shall be level to +1-114"
in all directions)
Pump Requirements: ft. TDH vs. GPM
Conditions:
Trench Spacing: Feet on Center
Soil Cover G inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
inches below pipe
Aggregate Depth: inches above pipe
inches total
**If applicable: / understand the system type specilled it different from the type specified on the application. l accept the specifications of this permit.
Owner/Legal Representativ nature: Date:
This Construction Authorization is subject to revocatio a site plan, , plat, 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 sub*it ompliance ` ~"Z aws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent: PL Date: `z Oil
strut ~Uthorization Expiration Date: 1
HTE# 0~~5- 6Sp2. Permit # ' -l ~
Harnett County Department of n blic Health
Site Sketch
t~ PROPERTY LOCATON: t w 1
ISSUED T0: tCrn~2~C5~N ~ficrF~~ ~Zl~ SUBDIVISION LOT #
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Authorized State Agent: 1aV Ell `T Date: a _
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Division of Environmental Health Property ID:
On-site Wastewater Section Lot
File
SOMSITE EVALUATION Code:
for ON-SITE WASTEWATER SYSTEM[
Owner:
Applicant:
Address:
~4AV
Proposed Facility: 3gU)Qf
-
1949): 3 bo
Design Flow (
Date Evaluated:
'rM
.
Property Size:
Location of Site:
Property Recorded:
Water Supply: Public
Individual [ J Well
[ J Spring
Evaluation Method: Auger Boring
[ ] Pit
(j Cut
Type of Wastewater: ewage
(J Industrial Process
(j Mixed
P
R
V
SOIL MORPHOLOGY
OTHER
F
.1941
PROFILE FACTO
RS
1
.1940
1942
L
Landscape
Horizon
.1941
119411
SoN
t943
1886
;
.1944f
E
Pos4lord
Depth
Structuref
conslsktrca
Weble
goat
3apra
_
Rssfc
0
S11009%
(IN.) I
Text"
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Other Factors (.1946):
Site Classification (.1048):
Evaluated By: C1 i
Others Present: M\KC L-^KC_-rz
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