IPACHTE# 0~-5s6~ Harnett County Department of Public Health 2 5 5 8 2
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: MP+2KS R o
ISSUED TO: rul<,G ~NC_ SUBDIVISION _ Q~.~,s~~dC2A LOT # "1'
NEWX REPAIR ❑ PANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: _ SF C) x(Cy -
Proposed Wastewater System Type: 4 -4 f- r,.r, d N Rt
Projected Daily Flow: 3L ~ GPD
Number of bedrooms: 3 Number of Occupants: max
Basement ❑Yes X No
Pump Required: ❑Yes ❑ No May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community 39 Public ❑ Well Distance from well tbb 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 issu
site is subject to revocation if the site plan, plat, or the intended use changes. The Impro,
the Laws and Rules for Sewage Treatment and Disposal and to conditions of this permit.
Date: fA j M3 `0 SEE ATTACHED SITE SKETCH
other permits. The permit holder is responsible for checking with appropriate governing bodies in meeting their requirements. This
net 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, .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: M. ~s~cZC~ ~N C_ PROPERTY LOCATION: Nl AQ~ 3 Q
SUBDIVISION NswEFaW LOT # M-
Facility Type: Q) New ❑ Expansion ❑ Repair
Basement? ❑ Yes No Basement Fixtures? El Yes XNo
Type of Wastewater System*' Co N'J ~ Q r4 (k L-_ (Initial) Wastewater Flow: N6,Q GPD
(See note below, if applicable
C, NJ
F_t-A"u N Pte' (Repair)
Installation Requirements/Conditions
Number of trenches
Septic Tank Size v 00 o gallons
Exact length of each trench LS'o
Pump Tank Size gallons
Trenches shali be installed on contour at a
Maximum Trench Depth of: a.0 - ag
(Trench bottoms shall be level to +1-114"
in all directions)
Pump Requirements: ft. TDH vs.
GPM
Conditions:
feet Trench Spacing:..._ Feet on Center
Soil Cover: 1 L inches
inches (Maximum soil cover shall not exceed
36" above the trench bottom)
Aggregate Depth:
C, inches below pipe
inches above pipe
inches total
If applicable: / understand the ryrtem type rpeciled it different from the type ,rpeci6ed on the app/ication. /accept the rpecillcationr of thi permit.
Owner/legal Representativ ature: Date:
This Construction Authorization is subject to revoca f the ite 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 subje to compliance h 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: I-,,. Date: I
nstruction Authorization Expiration Date:
HTE# Qc-S-3aS64 Permit # a-SS-
Harnett County Depailment of I -tblic Health
Site Sketch
PROPERTY LOCATON: MAQ
ISSUED TO: SUBDIVISION P~sH t~tD LOT # ~1 ct
Authorized State Agent: QS V~uv~ `i'oLyso2L6 Date: 8T
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)ivision of Environmental Health Property ID:
On-site Wastewater Section Lot #
File #
SOILSITE EVALUATION Code:
for ON-SITE WASTEWATER SYSTEM
Owner: Applicant:
Address:
Proposed Facility: 3 Q(Sjttcbrn 1.oME Design Flow (.1949): 366 re
Localbn of Site:
Water Supply: -w/J Public [ J individual [ 1 Well
Evaluation Method: `Auger Boring [ J Pit
Type of Wastewater _'Newags [ j Industrial Process
Date Evaluated:
Property Size:
Property Recorded:
[ J Spring
(j Cut
(j Mixed
[ I Other
P
R
p
F
SOIL MORPHOLOGY
.1941
OTHER
PROFILE FACTORS
1
L
E
0
.1940
Landscape
PosNt W
S k"1116
Horlron
Deptlt
IN.
.1941
stud"
Texhus
.1941
Consistenor
.1942
510111
Wetr P
Color
.1943
So9
Depth IN.)
i9U
Sapra~
Close
.1%4
I Rss1c'
Hoch
Pray ;
C"s
3 LTAR
L-'5'
(D _Li),
Ce -5
Q ~a/e
5
C_
4M
~S ~rv~
5.4
_
Description
Initial System
Repair System
Available Space (.1945)
/
v
Sys m eT pe(s)
CIC) )i
C-%-a
Other Factors (.1946):
Site Classification (.1948): 5
Evaluated By: Q~