IPAC w/ attachmentHTE# Ug-s a.a$-N Harnett County Department of Public Health 25613
Improvement Permit
A building permit cannot be issued with only an Improvement Permit p
PROPERTY LOCATION, / ~G.. ksIRd.
ISSUED TO /!1 )1Ck t k we Q SUBDIVISION ~W41- - LOT # ,3`
NEW V REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: I)
Proposed Wastewater System Type: a a5- Zu
Projected Daily Flow: to 4 _ GPD
Number of bedrooms: 13 Number of Occupants: max
Basement ❑Yes~ PIC
Pump Required:'BYes ❑ No ❑ MMax be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community LAS Public ❑ Well Distance from well feet Permit valid for. Ca'Five years
Permit conditions: ❑ No expiration
Authonzed State Agent:: ! c,--~- I , k , J , Date: 5 /j~ (2-04 9 SEE ATTACHED SITE SKETCH
The issuance of this permit by the afth 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 the 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, .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 lay ut
ISSUED TO: PROPERTY LOCATIO : /
SUBDIVISION --tc~ LOT # rf
Facility Type: er New ❑ Expansion ❑ Repair
Basement? ❑ Yes U" No Basement
T vex p fixtures? 11 ~ Yes~c~ No
Type of Wastewater System*P2J '14 : cry (Initial) Wastewater Flow: GPD
(See note below, if applicable
ro'`9p o E& Ae au4 ' kV (Repair)
Installation Requirements/Conditions Number of trenches a
Septic Tank Size 000 gallons Exact length of each trench feet
Pump Tank Size 1006 gallons Trenches shalt be installed on contour at a
Maximum Trench Depth of: o? Y- ✓ 0 inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
Pump Requirements: ft. TDH vs. GPM
JZ
Trench Spacing: Feet on Center
Soil Cover. /a2.- / F inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
inches below pipe
Aggregate Depth: inches above pipe
inches al
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r o +/~.5~ c :cam e)=r Q1e,- 4--k54
**If applicable: / understand the system type specified is different from the type specified on the appItalian. / accept the specifications of this permit
Owner/Legal Representative Signature:
This Construction Authorization is subject to revocation if the site plan, plat, or the intended use changes.
tonstNrnon Autnonzation 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 SKETCH
Authorized State Agen . J- Date: 9 /VXC f
Construction Authorization Expiration Date: V 2-Q i y
t
r z
Date:
Construction Authorization shall not be transferred when there is a change in ownership of the site. This
HTE# -1 J"yV Permit # d- 5- 1.3
Harnett County Department of Public Health
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Q t PROPERTY IOCATON:
ISSUED T0: SUBDIVISION c LOT # I
Authorized State Agent v, Date:
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7lvision of Environmental Health
Dn-site Wastewater Section
SOILSITE EVALUATION
for ON-SITE WASTEWATER SYSTEM
Owner:
Address:
Proposed Facility:
Location of Site:
Water Supply:
Evaluation Method:
Type of Wastewater.
Design Flow (.1949):
[ pl5'ubik Individual
(J16-ger Boring
( I Sawa"
JI 1""t.
Property 10:
Lot #
File
Code:
Applicant:
Date Evaluated:
Property Size:
Property Recorded:
( ) Well Spring
Pit Cut
[ J Industrial Process (J Mixed
[ I Other
P
R
0
F
SOIL MORPHOLOGY
.1941
OTHER
PROFILE FACTORS
L
E
o
.1940
Landscape
PosWW
Horlron
Depth
IN
.1941
Strudure/
Tsxtws
.1941
Conslstarc
mlirwralogy
.1942
8011
Wetrr' a
Color
.1943
Soo
Dopth N.)
198111
Sapral
Claw
i .1944
I Resir.
Hmis
.
Prof
Clan
& LTAR
C
' 7 C.~
/
~s LJ
a
Description
Initial System
Re al System
Available S ace (.1945)
,System Type(s
'a
Other Factors (.1946):
Site Classification (.1948): ~f
Evaluated By: