IPACHTE# og-s- 3 Harnett County Department of Public Health 2 5 5 8 4
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION:_ Nv¢s~zy P~
ISSUED T0: kEN~cE-S~t ~-u v+mt.a6g SUBDIVISION ~rlmc~:ttt->sasrcE LOT # _1*43_
NEW REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure:
Proposed Wastewater System Type: C'rvEr•-C.n"r,).-.
Projected Daily flow: "!I GPD
Number of bedrooms: -L- Number of Occupants: "i, max
Basement ❑Yes X No
Pump Required: ❑Yes ❑ No 4 May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community Public ❑ Well Distance from well CPO 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 issuanc2
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: 1? % Oo SEE ATTACHED SITE SKETCH
permits. The permit hold is responsible for checking with appropriate governing bodies in meeting their requirements. This
er it 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 T0: CS
Facility Type: _
PROPERTY LOCATION: ~v2S7 141
SUBDIVISION 4cocwl \cLC-- LOT #
X New ❑ Expansion ❑ Repair
Basement? ❑ Yes )~t No Basement Fixtures? ❑ Yes No
Type of Wastewater System** C.,'Z'\1 d't4-.L' (Initial) Wastewater Flow: WiQ GPD
(See note below, if applicable
~~°l ~~oUC~~Kf ~ Sysc~-tt~ (Ranairl
Installation Requirements/Conditions
Septic Tank Size woo gallons
Pump Tank Size gallons
Pump Requirements: ft. TDH vs.
Conditions:
Number of trenches 1
Exact length of each trench a0~ feet
Trenches shall be installed on contour at a
Maximum Trench Depth of:.-_3(-_ inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
GPM
Trench Spacing: 9 Feet on Center
Soil Cover. inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
Aggregate Depth
inches below pipe
4 inches above pipe
inches total
**If applicable: / understand the system type specified is different from the type specified on the app/icatioa. /accept the specifications of this permit.
Owner/Legal Representative S' ture:
This Construction Authorization is subject to revocation
Construction Authorization is sttAj~Q tycompliance
Date:
or the intended use changes. The Construction Authorization shall not be transferred when there is a change in ownership of the site. This
:~%Ld Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent: Date: $ 17 0 `i
Constructio uthorization Expiration Date: --~1
HTE# Permit # a`SS
Harnett (county Department of 1' blic Health
Site ketch
PROPERTY LOCATON: N\j suLl q.v
ISSUED TO: SUBDIVISION ~lmc~~N~~zf LOT #
Authorized State Agent: ~L~~ECL'Z13LiCS~o(~ Date: S' 1--j O
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rparuntlntur c11V11V11111tt111• I1t1d4U1, a11U IvdlUldl naa~ul~aa Property 10:
vision of Environmental Health Lot tt
n-site Wastewater Section File 11:
SOIL/ SITE EVALUATION Code:
for 0,-4-SITE WASTEWATER SYSTEM
Applicant:
Owner:
Address:
Iroposed Facility: i-1 Design Flow (.1949): Ly'id
Location of Site:
Pubttc (J Individual Well
Water Supply:
Evaluation Method: u
ger Boring Pit Industrial Process
Type of Wastewater
R
SOIL MORPHOLOGY
D
.1941
F
1
.1940
n
i
1941 .1941
L
E
L
POSNWW
zo
Hor
Depth
Struckmw Comtetence
9
S %
IN.
Tsxtras
c) - Lj-6
Date Evaluated: 4'~a1Q~'1
Property Size:
Property Recorded:
[ j Spring [ j other
[ j Cut
( [ Mixed
OTHER
PROFILE FACT
.1942 .
Soill .1943
Wet reaN Sol
Am .1944
Sapid Re'
LTAR
-8
S e)
Description Initial S stem alr System Other Factors (.1946):
Available Space (.1945) Site Classification (.1948):
ro. < '
7cw , " Fvaluated Bv: 0\
n2 io J ' "1