IPACHTE# 0'-~)-~ =z x555--- Harnett County Department of Public Health 2 5 4 2 5
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION:~1Q [y~Z IZOe- /pW /Z
ISSUED TQ; cn 44 L~l /~/ylfS ~C- SUBDIVISION LOT #
NEW ~ REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: 1= t
Proposed Wastewater System Type: flGt~ Ct
Projected Daily Flow: GPD
Number of bedrooms: Number of Occupants: max
Basement ❑Yes No
Pump Required: es ❑ No ❑ MMayK required based on final location and elevations of facilities
Type of Water Supply: ❑ Community ld Public ❑ Well Distance from well feet Permit valid for:
Permit conditions:
Ld'Five years
❑ No expiration
Authorized State Age Date: e-4d,376 SEE ATTACHED SITE SKETCH
The issuance of this permit by 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 e, 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, .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: -mat} /~Dy..ea PROPERTY LOCATION: BIZ /yS2_ //2ir%71•£ /Z~
2/New SUBDIVISION., 5-7,.) a-~iCo-,J -LOT # 'V
Facility Type: ❑xpansion ❑ Repair
Basement? ❑ Yes No Basement Fixtures? ❑ Yes Z No
Type of Wastewater System- 0"3% 17X--WC.;r 2 -A - (Initial) Wastewater Flow: .3470 GPD
(See note below, if applicable '
2'!44IZ UZ-q d (Repair)
Installation Requirements/Conditions Number of trenches Z
Septic Tank Size J006 gallons Exact length of each trench I Z cD feet
Pump Tank Size /O(06 gallons Trenches shall be installed on contour at a
Maximum Trench Depth ofo~J inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
Pump Requirements: ft. TDH vs. GPM
Trench Spacing: 7 Feet on Center
Soil Cover inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
Aggregate Depth:
Conditions: i4zJLr ~/c z - ~L ~ itU k/ yz/~-5
lP inches below pipe
Z inches above pipe
/Z inches total
*If applicable: l understand the ryrtem type roecilled it different from the type .rpecibed on the application. l accept the tpeci6cations of this permit.
Owner/Legal Representative Signature: Date:
1. -.1", w ",vuuon if me ate plan, plat, or the mtenoeo use coanges. the conmuchon Authorization shall not be transferred when there is a change in ownership of the site. This
Construction Authorization is subject to compliance with the provisions of the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE WFTCH
Authorized State Ag . Z Date: S - t 3 - 6"1
Construction Authorization Expiration Date: 9 3 -
HTE# S- ZZSSS-" Permit # 2~L~Z 5
Harnett County Depailment of Public Health
Site Sketch
PROPERTY LOCATON: -37Z/q5-Z .u~tfcr~ c
ISSUED TO: --2<0 f Ce. Brag- 5 -77 jC SUBDIVISION ~o~.t Cma s i2~7G~' LOT # _
Authorized State Age Date: 8-/.1- - d 9
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3Ivision of Environmental Health
Dn-site Wastewater Section
Owner:
Address:
Proposed Facility:
Location of Site:
Water Supply:
Evaluation Method:
Type of Wastewater.
SOILSITE EVALUATION
for 0'4-SITE WASTEWATER SYSTEMM
JI iuul.
Property ID:
Lot #
File
Code:
Applicant:
Design Flow (.1949):
( 415ubllc [ j individual Well
( uger Boring [ ] Pit
( 75~ge [ j Industrial Process
Z 7 -
Date -
Date Evaluated: Z 412
Property Size: D q
Property Recorded:
[ ] Spring (j Other
[ ] Cut
( ] Mixed
P
R
p
F
SOIL MORPHOLOGY
.1941
OTHER
PROFILE FACTORS
L
E
ft
.1940
Landsc*e
Position/
slopes
1-10il n
Depth
IN.
.1941
StrucNirs/
Tsxtwls
.1941
consists"
mkwmkw
.1942
Soi
WsbMw
cow
.1943
Sol
00110 (IN.)
i 9m
Sera
Clap
~ I%*
Rene'
ftorht
Prordi
Class
d LTAR
1
O - Zo
51.
0GJit 6,-4 .J P
1
Lo
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Cam. tx ~.P.
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Z
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Description
Initial System
Repair stem
Available Space (.1945)
System Typels) -
q
,p
get U'
Other Factors (.1946):
Site Classification (.1948):
Evaluated By: f' d / 0
°/Z'C-1j