IPAC RHTE#0g-,5--,UC?5,e Harnett County Department of Public Health 2 5 6 2 5
Improvement Permit
A building permit cannot be issued with only 71 Improvement Permit
PROPERTY LOCATION: Ck k1Q-,4 k
ISSUED TO: Li-~~ a.~i~ ✓`z ~ r+tie, SUBDIVISION _ _ 6,~g-(-o LOT # v`I
NEW 2-' REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
`t
Type of Structure: rp SO 0
Proposed Wastewater System Type: S vc :cry. cri/r ~e
Projected Daily Flow: 6 GPD
Number of bedrooms: 3 Number of Occupants: C max
Basement ❑Yes 21
Pump Required: ❑Yes ❑ No [~J<ay be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community E~T' Public ❑ Well Distance from well feet Permit valid for. CSI Five years
Permit conditions: ❑ No expiration
Authorized State Agent:: ,-12~ k-(/~/ Date: '7/2SEE ATTACHED SITE SKETCH
The issuance of this permit by ealth 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. J
ISSUED T0:~-~~Je ~o p PROPERTY LOCATION: V~ C k e,
SUBDIVISION v~ y LOT #
Facility Type: i~ New ❑ Expansion ❑ Repair
Basement? ❑ Yes ~No Basement Fixtures? Yes ❑ No
Type of Wastewater System** c41< 1 J 1-" J n-, (Initial) Wastewater Flow 5'03 GPD
(See note below, if applicable
(Repair)
Installation Re uirements/Conditions Number of trenches •z
Septic Tank Size gallons Exact length of each trench .7 r- feet Trench Spacing: Feet on Center
Pump Tank Size gallons Trenches shall be installed on contour at a Soil Cover: inches
Maximum Trench Depth of: 0 G 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
Con 'tions73) -0.kt✓" 4-1 6,- fk,, 3A ~ C} { ( - ~;C r inches total
*If applicable: / onderrtand the ryrtem type rpechried it different from the type ,oecifled of the app&atiofl. / accept the rpecificationr 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 Age . % Date: 9 2~
Construction Authorization Expiration Date: -Z e261
HTE# X9-5=x.75,2 Permit # Z Z-r-
Harnett Connty I)epartment of 1'iiblic Health
Site Sketch
PROPERTY LOCATON: ► C~ Ki
ISSUED TO: SUBDIVISION o f o er LOT #
Authorized State Agen Dat/- 2 2 °d 9
-O
<U
Department of Environment, Health and Natural Resources
Division of Environmental Health
On-Site Wastewater Section
SOILISITE EVALUATION
for ON-SITE WASTEWATER SYSTEM
Owner: Applicant:
Address: Date Evaluated: cl y a7
Proposed Facility: Design Flow (.1949):
Location of Site: Property Recorded:
Water Supply: LJ Public ❑ Individual ❑ Well
Evaluation Method: ger Boring ❑ Pit ❑
Type of Wastewater: C.l Sewage ❑ Industrial Process ❑
Sheet:
Property ID:
Lot
File
Code:
Property Size:
❑ Spring ❑ Other
Cut
Mixed
P
R
O
F
I
1940
OIL MORPHOLOGY
.1941
THER
PROFILE FACTORS
L
E
#
LarAscape
Position/
Slope %
Horizon
Depth
(In.)
o- ~ ~1
.1941
Structure/
Texture
G 5-Z,
.1941
Consistence
Minemlolty
.1942
Soil
wetness/
Color
.1943
Soil
DW& IN.
.1956
Sapro
Class
.1944
Restr
Hong
Profile
Class
& LTAR
617
47 ~
JC/
f- f
If -p
Description
Initial
S stem
Repair System
Other Factors (.1946):
Site Classifi
ti
1948
Available S ce ,1943
ca
on
E
l
d B
System Type(s)
~
.
C°
va
uate
y r~--
Site e LT AR
t.
f
Others Present: