IPAC w/ attachmentHTE# y(. Harnett County Department of Public Health 2 5 61 4
Improvement Permit
A building permit cannot be issued with only an Improvement prmit
PROPERTY LOCATIO A
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ISSUED T . SUBDIVISION
u1,1A LOT # f.3
NEW ( REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: 0
Proposed Wastewater System Tyge: to t~ cu
Projected Daily Flow: c0 GPD
Number of bedrooms: .3 Number of Occupants: L max
Basement ❑Yes Goo
Pump Required: Pr es ❑ No ~MMay be required based on final location and elevations of facilities
Type of Water Supply: 11 Community EVPublic ❑ Well Distance from well feet Permit valid for. o'>e years
Permit conditions: ❑ No expiration
Authorized State Agent.: Date: 20o q SEE ATTACHED SITE SKETCH
The issuance of this permit by elm, alth 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 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 taws 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 layout.
ISSUED TO: 66 c,,4 K- PROPERTY LOCATI N:.~~
SUBDIVISION LOT # ~f-?
Facility Type: 'ri ltd" New ❑ Expansion ❑ Repair
Basement? ❑ Yes No Basement Fixtures? 1:1 Yes El No
Type of Wastewater System" - 1 4-) , e^ wS~~ (Initial) Wastewater Flow: 26 ~ GPD
(See note below, if applicable -
P~,~ n ~a ~,-f4 l~~J u c. t. e' c~ (Repair)
Installation Requirements/Conditions Number of trenches .2
Septic Tank Size <X 0 gallons Exact length of each trench 7+f' feet Trench Spacing: Feet on Center
Pump Tank Size /000 gallons Trenches shall be installed on contour at a Soil Cover, /o1- /0 . inches
Maximum Trench Depth of. - -3U inches (Maximum soil cover shall not exceed
(Trench bottoms shall be level to +/-1/4" 36" above the trench bottom)
in all directions)
Pump Requirements: ft. TDH vs. GPM inches below pipe
Aggregate Depth: inches above pipe
Conditions: ls•~~}er ~..~c 4-o & /oft -4g,~,. s,^
-j pc.t-~ inches total
~
*If applicable: /understand the system type speciled is different from the type speciled on the application. 1 accept the specifications of this permit.
Owner/Legal Representative Signature: Date:
This Construction Authorization is subject to revocation 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 compliance with the provisions of the Laws and Rules for Sewage Treatment and Disposal and to the condition{ of thi% permit tFF ATTACHFD CITF UFM4
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Authorized State Agent:
Date: C4
9
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Construction Authorization Expiration Date: /
NTE# 4 4-S-o2fl2lo Permit # / tl
Harnett County Department of Public Health
Site Sketch
PROPERTY LOCATON:zew lllW k ,eo
ISSUED T0: , /ci SUBDIVISION a n,,4 LOT # 5-3
Authorized State Agent: 4..~ Date: 3,27
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division of Environmental Health
3n-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):
[ I Pubilc (J Individual
( J Auger Boring
(J Sewage
011""%.
Property ID:
Lot
File
Code:
Applicant:
Date Evaluated:
Property Size:
Property Recorded:
[ 1 Well [ I Spring [ [ Other
[ [ Pit [ j Cut
(j Industrial Process (j Mixed
P
R
p
F
SOIL MORPHOLOGY
.1941
OTHER
PROFILE FACTORS
I
L
E
>Y
.1940
Laridecape
PosNNW
Slope%
Fbrim
OWM
IN.
.1941
Sbud"
Tsxtut.
.1941
Corralstencle
mlir"M
.1942
Sort
Webww
color
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Sol.
IN.)
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Sol"
Clsss
~ .1944
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Description Initial System Repair System
Available Space (.1945)
S stom Type(s)
Other Factors (.1946):
Site Classification (.1948):
Evaluated By: