IPACHTE# og-,s Harnett County Department of Public Health 2 5 6 3 2
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LO(AT!AN:
Cr v o ww- I.
ISSUED TO: ~ C • YT-
t-&". Ic~ S SUBDIVISION 4A S: 0'--d fa- LOT #
NEW I' REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: :C F A o 16
Proposed Wastewater System Type:
r"Y4e2~d
Projected Daily Flow: 3~,G GPD
Number of bedrooms: -13 Number of Occupants: Q~ max
Basement ❑Yes 21o
Pump Required. ❑Yes o Maybe required based on final location and elevations of facilities
Type of Water Supply: El Community 0 "'Public ❑ Well Distance from well feet Permit valid for. ~ years
Permit conditions: ❑ No expiration
Authorized State Agent:: xF l~ Date: / i•~2W SEE ATTACHED SITE SKETCH
The issuance of this permit by the th 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: J-1&; 1&; /4 PROPERTY LOCAT N: / %CS o / a~ tr kd-
SUBDIVISION G o,, & .,L+ ff ~ LOT
Facility Type: If- F~ ~ew ❑ Expansion ❑ Repair
Basement? ❑ Yes ❑ No Basement Fi tures7 ❑ Yes ❑ No
Type of Wastewater System** o2,5-Y4 ,eA f~S-1--~ (Initial) Wastewater Flow: J(c Cl GPD
(See note below, if applicable
0257 c+~~J- (Repair)
Installation Requirements/Conditions Number of trenches
Septic Tank Size --L /000 gallons Exact length of each trench / S-0 feet
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of. 16 - JQ inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
Pump Requirements: ft. TDH vs. GPM
Trench Spacing: Feet on Center
Soil Cover: rot-16 inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
p Aggregate Depth:
Conditionso 0--, (`o t% eJI~av~ed
inches below pipe
inches above pipe
inches total
**If applicable: / understand the system type specified if different from the type specified on the application. / 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 chance in ownershin of the site. This
lonstructron 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 A en
S Date: Zoo
Construction Authorization Expiration Date: l0 4 aai-/
HTE # O z7 )-I Permit # ~ z
Harnett Counter .Department of ll~ blic Health
Site Sketch.
PROPERTY LOCATON: rte.
ISSUED TO: c,~c ( X-I lil-1-1 SUBDIVISION a ' . Jlc LOT # 3
Authorized State Agent Date: / Q~cxt 9
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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
Owner. Applicant:
AAdress:
Proposed Facility:
Location of Site:
Water Supply:
Evaluatfa® Method:
Type of Wastewater:
Date Evaluated: 1 ~ 1, p
Design Flow (.1949):
Property Recorded:
[Public ❑ Individual ❑ Well
[3 Auger Boma El Pit ❑
[Sewage ❑ Industrial Process ❑
Sheet:
Property Ia
Lot
File
Code:
Property Size:
❑ spring ❑ Other
cut
Mixed
P
R
O
F
I
L
940
L
d
SOIL MORPHOLOOY
1941
OTHER
PROFILE FACTORS
E
#
o
scape
Position/
Slope %
Horizon
Depth
(1a)
1941
Structure)
Texture
.1941
Comitence
Minxalo
.1941
Soil
wetness!
Color
.1943
Soil
Depth W.
.1956
SNxo
Clay
.1944
Rotr
Hartz
Proms
Circa
& LTAR
C)' I
G' /mil
~l ✓
l
n
r41
Description
Available 3
SYAGM
Sae LTAR
ce .1945
a
laitiai
3 stem
Repair System Other Factors (.1946k
Site Classification .1948 . Pf
( r
Evaluated By: ,r4,,--
o Oam Present: