IPAC RHTE#()I-.5-ao-;aslgR Harnett County Department of Public Health 25515
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: o`Z31
ISSUED T0: ~ Oql\c S SUBDIVISION CAZOktr•a 9e11.N-n5 LOT #
NEW$- REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Constructign Authoriz0on Issuanc
Type of Structure: Ffl ~0 x3~ (Z• A(l t&AA OT) 5~~-11CA
Fri IiJ~. o f~rL
Proposed Wastewater System Type: SnA"
Projected Daily flow: 2 (Q o GPD ,Gy r z S; c~t 4, /t)w ~C bt f r.rJ
Number of bedrooms: 3 Number of Occupants: Co max
Basement ❑Yes ;9-No ID 4,1 lJtjzj S~t.c Sys r,~
Pump Required: ❑Yes ❑ No May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community Public ❑ Well Distance from well 103 feet Permit valid for. ~ Five years
M Pe it conditions: ~C- cnS. G- Fcr,p►ii, V , I,~ JA t c6Es ❑ No expiration
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Authorized State Agent:: d= J Date: 1o - 9- 0 9 SEE ATTACHED SITE SKETCH
The issuance of this permit by the 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, .1951, .1958. and .1959 are incorporated by references into this permit and shall be met. Systems shall be installed in accordance
with the attached syystteem layout.
ISSUED T0: ~tM6-r- I'~att'SLS PROPERTY LOCATION: OoIf
SUBDIVISION ~'~}2of tw SL'A --1n S LOT # /0 -Z
Facility Type: SEC) "~~X~S Z9--New ❑ Expansion ❑ Repair
Basement? ❑ Yes [K- No Basement Fixtures? ❑ Yes 4KNo
Type of Wastewater System" s,. (Initial) Wastewater Flow: 363 GPD
(See note below, if applicable (n~
" f. E 1~c Qj z (Repair)
Installation Requirements/Conditions Number of trenches I
Septic Tank Size ID gallons Exact length of each trench 1 S3 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: 'd `4 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: inches total
*If applicable: /understand the system type specified is different from the type specified on the app/ication. / accept the specifications of this permit
Owner/legal Representative Signature: Date:
-1-.1-1- 11 ...,,t.11 1-11,, 1-11 -1 y'a"a Y14b U< - ❑-1-LI 1UC Ufauges. me cunsuucuon Rumonzanon snap not u transterreo wnen there is a change in ownership of the site. This
tonstrucnon 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: r Date: I _
Construction Authorization Expiration Date: (~-0 `t- ao I
HTE# Q~ ~-00 Q ►K Permit # 0 55- 1 S
Harnett County IDepartment of INtblic Health
Site Sketch
PROPERTY LOCATON: 1)31
ISSUED TO: CA(r'~Cr-Wc( ff poY a SUBDIVISION ?O/, vw, ,_Srq ),-,,A S LOT #
Authorized State Agent Date: /0-9-31
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Division of Environmental Health
On-site Wastewater Section
S01USITE EVALUATION
for ON-SITE WASTEWATER SYSTEM
Owner:
Address:
Proposed Facility:
Location of Site:
Water Supply:
Evaluation Method:
Type of Wastewater:
Design Flow (.1949):
[ J Public Individual
( j Auger Boring
(j Sewage
JI ICCI.
Property ID:
Lot
File
Code:
Applicant:
Date Evaluated:
Property Size:
Property Recorded:
[ J Well [ J Spring (j Other
[ ] Pit Cut
Industrial Process (J Mixed
P
R
O
F
SOIL MORPHOLOGY
.1941
OTHER
PROFILE FACTORS
I
L
E
#
.1940
Landscape
Position/
Slope%
Horizon
Depth
IN.)
1941
Structure/
Texture
.1941
Consistence
Mineralogy
.1942 .
Sol
Wefnesai
Color
.1943
SON
Depth IN.)
.1958
Sapr*
Class
.1944
Restr
Horiz
Profile ;
Gass
3 LTAR
So N
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C)) L,
tt
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Description
Initial System
Repai System
Available Space (.1945)
System Type(s)
Site LTAR
r
t
Other Factors (.1946):
Site Classification (.1948): I
Evaluated By: I t,/
Others Present: