IPACHTE#0 -s=aWoO Harnett County Department of Public Health 25610
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
p PROPERTY LOCATION, VA /f% l
ISSUED TO- SUBDIVISION s ~ cst LOT # _ 0
NEW V REPAIR ❑ , EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: SFp J(y
Proposed Wastewater System Type: C Q.,Ue.h~ `K.Yk-
Projected Daily Flow: 3b C GPD
Number of bedrooms: 3Number of Occupants: L max
Basement ❑Yes Fe o
Pump Required: ❑Yes ❑ No F'Ma a required based on final location and elevations of facilities
Type of Water Supply: ❑ CommunityPublic f"L
❑ Well Distance from well feet , Permit valid for. B Five years
Pgrmit conditions: ~6,4 C_ A lr ~e u 0,cc y-6; ► , ~y w ❑ No expiration
Authorized State Agent.: we.~ Date. .200 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 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 payout
ISSUED TO: 1 R_J ?r`fz C..rC PROPERTY LOCATION:- 5-Q
Facility Type: S► New
Basement? ❑ Yes No Basement Fixtures? ❑ es
Type of Wastewater System** CO A VIL ti ~
(See note below, if applicable
C6~~e~~► au (Repair)
Installation Requirements/Conditions Number of trenches
Septic Tank Size X000 gallons Exact length of each trench 070 feet
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of: a(116 inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
Pump Requirements: ft. TDH vs. GPM
A-t CL ~G ! 1 t to
(Initial) Wastewater flow: 6 d GPD
Trench Spacing: c. Feet on Center
Soil Cover: /P?- `/'8 inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
Aggregate Depth:
inches below pipe
inches above pipe
/Z inches total
**If applicable: /understand the system type specified is different from the type specified on the app/ication. /accept the rpeci~catianr 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 conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent Date: 9 200
Construction Authorization Expiration Date: a 0
SUBDIVISION c oa' LOT # / y
❑ Expansion ❑ Repair
❑ No
HTE# 4 9 S= d)- 6-7 Permit # 25-- 10
Harnett (bounty -Department of 11tihlic Health
Site ketch
PROPERTY LOCATON:
ISSUED TO: 4t- SUBDIVISION LOT # /O
Authorized State Agent: 1 ..u, Date:
? 1(1120 0 g
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~7
Department of Environment, Health and Natural Resources Sheet:
Division of Environmental Health Property ID
On-Site Wastewater Section Lot
File
SOIUSITE EVALUATION Code:
for ON-SITE WASTEWATER SYSTEM
Owner. Applicant:
Address: Date Evaluated: f
Proposed Facility: Design Flow (.1949): Property Size:
Location of Site: Property Recorded:
Water Supply: [Public ❑ Individual ❑ Well ❑ El Spring ❑ Other
Evaluation Method: Avger Boring ❑ Pit cut
Type of wastewater: Sewage ❑ Industrial process ❑ Mixed
P
R
O
F
I .1940
L Lars cape Haman
E Position/ Deptli
# Slope %
/
SOIL MORPHOLOOY
.1941 OTHER
PROFILE FACTORS
.1942
.1941 .1941 Soil .1943 .1956 .1944
Stuc~re/ Consistence wetneas/ Soil SWO Re&
Te~dun Minenlo Color IN. Class Horiz
rofile
r<AR
y
Description Initial
s st
Available S cc .1945
stem s C
Site LTA
Repair System Other Factors (.1946):
S ite Classification (.1948):
Evaluated By:
Others Present: