IPACHTE# q 5DO-- 9 ) -7 ?q Harnett County Department of Public Health 2 5 51 3
Improvement Permit
A building permit cannot be issued with only an Improvement Permit ~2A
tt &4,0- In PROPERTY LOCATION: 5/Z 1)-12 - LAW(f cc 1
ISSUED T0:(~ C2 5~%~ SUBDIVISION LOT #
NEW RE ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance: / a el c
Type of Structure: &D x M R S FD
Proposed Wastewater System Type: 9ucna t sj).
Projected Daily Flow: 3 (cam GPD /
Number of bedrooms: Number of Occupants: C> max
Basement ❑Yes No
Pump Required-Yes ❑ No ❑ May be required based on final location and elevations of facilities
Type of Water Suppl : El Community '54 ublic El Well Distance from well 33° feet Permit valid for. XFive years
Permit conditions: S r- -11 ( LA .n 15)~K -t t 1 t k/ ❑ No expiration
A107/I:~ L E "-Ar't14 his 13` Anti !1qr4 .f-rrr7c 5'-,-fem.
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Authorized State Agent:: Date: 0g- ff I I SEE ATTACHED SITE SKETCH
The issuance of this permit by th 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 layout
ISSUED TO: EA&(Z~J PROPERTY LOCATION: ld-7 2
SUBDIVISION LOT #
Facility Type: 5 R) - (o3 'y! `E li- New ❑ Expansion ❑ Repair f , d '51ft
Basement? ❑ Yes ZZ- No Basement Fixtures? ❑ Yes ~o
Type of Wastewater System** (Initial) Wastewater Flow: 3 GPD
(See note below, if applicable g~
C~ SI- ct- - 3A s 1-~ (Repair)
Installation Requirements/Conditions Number of trenches -
Septic Tank Size 1DJ C> gallons Exact length of each trench I &Q_ feet
Pump Tank Size J033 gallons Trenches shall be installed on contour at a
Maximum Trench Depth of. .--I inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
Pump Requirements: ft. TDH vs. GPM
Conditions:
Trench Spacing: Feet on Center
Soil (over. _ inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
Aggregate Depth:
inches below pipe
inches above pipe
inches total
**If applicable: / undeatand the system type specified is different from the type specified on the app/ication. / accept the soecipcations of this permit
Owner/legal Representative Signature: Date:
This construction Authorization is subject to revocation if the city nlan nlat nr rho inron&A uco rhinnot Th< rnotrrn~Fen Anrh~n,~d„~ .h,11 „nr k.-.4.. 4 .-k.. A- 4 i .L..:.. II.:.
a - _.._..b_ _...._..,...r
Construction Authorization is subject to co ante 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: - I ~ ' t
Construction Authorization Expiration Date: D I- (L 33114
HTE# da 1~ 4 Permit # ~ ~~'7_
Harnett (Voting Department of Public Health
Site Sketch.
J PROPERTY LOCATON:~ Z
ISSUED TO: VA22
Q ~ SUBDIVISION LOT #
1 ¢d 5/rc
Authorized State Agent: Date: 6
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Department of Environment, Health and Natural Resources
Division of Environmental Health
On-Site Wastewater Section
SOIIJSITE EVALUATION
for ON-SITE WASTEWATER SYSTEM
Sheet:
Property ID:
Lot
File
Code:
Owner. Applicant:
Address: Date Evaluated: 9-) . 9
Proposed Facility: Design Flow (.1949): ~Z Property Size: 1- 11
Location of Site: Property Recorded:
Water Supply: Public [T Individual ❑ Well [I Spring ❑ Other
Evaluation Method: uger Boring ❑ Pit ❑ Cut
Type of Wastewater. -a Sewage ❑ Industrial Process ❑ Mixed
P
R
O
F
I
1940
OIL MORPHOLOGY
.1941
THER
PROFILE FACTORS
L
E
#
Landscape
Position/
Slope %
Horizon
Depth
00
.1941
Structure)
Texture
.1941
Conista we
Mineralogy
.1942
Soil
wetnnew
Color
.1943
soil
Deptit (IN.)
.1936
SWO
Class
.1944
PC&
Hoiz
Profile
Clan
& LTAR
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Description
Initial
System
Repair System
Other Factors (.1946):
Site Classification (
1948):
Available Space .1943
.
Evaluated B
:
i
System s
f
y
,
Oth
P
md:
Site LTAR
ers
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