IPACHTE#OS ~ Harnett County Department of Public Health 2 5 5 8 0
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
ISSUED TO: le) 1 c c r~Ez.Z ~iac.\E-5 `N L PROPERTY LOCATION:-N1 p&xs
s~Gt o~ #
NEW X REPAIR ❑ PANSION ❑ SUBDIVISION Site Improvements required prior to Construction Authorization LOT Issuance:
Type of Structure: ~'~SS ~ Ib
5~9 (,tis"
Proposed Wastewater System Type: e 1~r~
PF, 4,
rojected Daily Flow: 'mod GPD
Number of bedrooms: 3 Number of Occupants: C, max
Basement ❑Yes >1 No
Pump Required:'IYes ❑ No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community Public ❑ Well Distance from well t no feet
Permit conditions: Permit valid for. Five years
❑ No expiration
Authorized State Agent:: - -1 Q
The issuance of this permit by the Health Department in no way guarantees the iss
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: B »~Oq SEE ATTACHED SITE SKETCH
of other permits. The permit holder is responsible for checking with appropriate governing bodies in meeting their requirements. This
v 't 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 .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: '3L ELL \~o C- PROPERTY LOCATION:
SUBDIVISION _ ~s"tAes✓ ciR."p
Facility Type:
New ❑ Expansion ❑ Repair
Basement? ❑ Yes N
o Basement Fixtures? ❑ Yes -A No
Type of Wastewater System** Qv n,p 1 o C
r v
(See note below, if applicable
o +w
o" ~l
N ene l C
Cv,,, I Esv~No " (Repair)
Installation Requirements/Conditions
Number of trenches I
Septic Tank Size ► Oa o gallons
Exact length of each trench &OD feet
Pump Tank Size ob o gallons
Trenches shall be installed on contour at a
Maximum Trench Depth of. 1g -alt inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
Pump Requirements: ft. TDH vs.
GPM
Conditions:
LOT # Ico3
(Initial) Wastewater flow: 3j~0 GPD
Trench Spacing: Feet on Center
Soil Cover. inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
inches below pipe
Aggregate Depth: Q1 inches above pipe
1:~. inches total
**If aoolicable /understand the system type rpeoiTed /s different from the type pacified on the app/ication. /accept the rpecifications of thi permit.
Owner/Legal Representative Signature:
This Construction Authorization is subject Date:
,{o gvocation if the 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 subject to complianE~wrt s of the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent:
Date:
truction Authorization Expiration Date:
HTE# Cc~ Permit # r~~ (D
Harnett County Department of Public Health
Site Sketch
PROPERTY LOCATON: ~ ~2u QZ
ISSUED T0: o C-- 'j ~N C- SUBDIVISION LOT # 103
Authorized State Agent: - Lw~t tai Date:
Cclhlvj~-IV ) vNC L-
i
Li ^x S
q
Q
IV
G
Jepa►ullant us Clovis Uslim "n, rivdUll, d11U 1`Idluldl rNtlbuUl UMP 131Rptll.
)ivision of Environmental Health Property ID:
On-site Wastewater Section Lot #
File
SOILSITE EVALUATION Code:
for Or-SITE WASTEWATER SYSTEM
Owner: Applicant:
Address:
Proposed Facility: Hc1 Design Flow (.1949): ~j
Location of Site:
Water Supply: 'tj,,Pub#c Individual Wei
Evaluation hlethod: 'IlAuger Boring Pit
Type of Wastewater: Sewage Industrial Process
Date Evaluated:'~j
Property Size:
Property Recorded:
I ) Spring I J other
( ) Cut
(I Mixed
P
R
0
F
SOIL MORPHOLOGY
.1941
OTHER
PROFILE FACTORS
1
L
E
#
.1940
Larxiscape
Posi lloW
S %
Host=
Depth
IN.
.1941
Sbud"
Texture
.1941
Consistence
mir"InIllm
.1942.
Sol
Wabvne
Color
.1941
Solt .
000 M.
.119011111
Saprar
Ciae
.194t
I ROW.
Hors=
,
Prof
Cie"
& LTAR
C)
C L S
tu5 "a
r~
G. L_ 5
Description
Initial stem
Repair System
Available Space (.1945)
System T pe(s)
p~,^
ca
Pu-9
cc"
Other Factors (.1946):
Site Classification (.1048):
Evaluated By, C-