IPACH T E # 0 .1:? 2-2, Harnett County Department of Public Health 2 5 6 3 3
Improvement Permit
A building permit cannot be issued with only a Improvement Pgrmit
S41
ISSUED TO
, c
l~l
PROPERTY LOCATIO : : pro / e
(e
.
:
NEW
rJ SUBDIVISION
LOT#_
REPAIR ❑
EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
f
Type of Structure:
O 0
Proposed Wastewater System Type:
cZS" _ AO_,ni v
Projected Daily flow:
GPD
Number of bedrooms:
3
Number of Occupants: - max
Basement ❑Yes
lo
Pump Required: ❑Yes
9 -I o
❑ May be required based on final location and elevations of facilities
Type of Water Supply:
❑ Community ❑ Well Distance from well feet Permit valid for.
EI-Tive years
Permit conditions:
❑ No
i
i
exp
rat
on
Authorized State Agent:: Date: rt ~ CIO 9 SEE ATTACHED SITE SKETCH
The issuance of this permit by th ealthe•R 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 system layout
ISSUED TO: -14 e. PROPERTY LOCATI : sc^ ed.
SUBDIVISION 'R'_ LOT #
Facility Type: 2'-N-ew ❑ Expansion ❑ Repair
Basement? ❑ Yes 9?-lo- Basement Fixtures. Yes No
Type of Wastewater System** 0~ .A ,c~ '.e,~J~,1 (Initial) Wastewater Flow: Jam' GPD
(See note below, if applicable
02~ o ~c ~'vlc._ (Repair)
Installation Re uirements/Conditions Number of trenches
Septic Tank Size gallons Exact length of each trench 7L5__ feet
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of: f IS 1 1~3 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: IbL -16 inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
Conditions: c;
Aggregate Depth:
inches below pipe
inches above pipe
j inches total
**If applicable: !understand the tyrtem type specified is different from the type roeciped on the app/ication. / accept the rpec1)1rcat1onc 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 complia 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: 2Qc,
Construction Authorization Expiration Date: a of
HTE# a 9 ~ 9 -:~a2k Permit # -2j--V,7
Harnett Comity I)epartmernt of Public Health
Site Sketch
ff l~ PROPERTY LOCATON:
ISSUED TO: ~/d'r SUBDIVISION a Q LOT #
Authorized State Agent: Date: /O/ Yr~dQ i
r
1
IpI
J oe
C
T
Department of Environment, Health and Natural Resources Shed:
Division of Environmental Health Property ID:
On-Site Wastewater Section Lot
SOI ISTTE EVALUATION File
for ON-SITE WASTEWATER SYSTEM Code,
Owner, Applicant: J
/
Addrm:
eC19
Date Evaluated: Pu
Proposed Facility:
Design Flow (.1949): Property Size:
Location of Site:
Wad
r Su
l
Property Recorded:
pp
y:
e
Evaluation Method:
[Tublic ❑ Individual C] Well ❑ Spring ❑ Other
uger Boring ❑ Pit ❑ Ce
t
P
Type of Wastewater
l
sewage
❑ Industrial Process ❑ Mixed
P
R
O
P
I
SOU. MORPIIOLOOY OTHER
.1940
.1941 PROFILE FACTORS
E
E Position/ Depth
Slope
# % (la.)
.1941
.1941 .1941 Soil
1943 .1936
shuck" C
"
.1944 Profile
on
eom watneow Soil SWO
Teadun mkwaloff Color Depth (IN, Clna
G ZY
IC---
ReW Clam
Hosiz # LTAR
V
U
~7
VZ-
-A
Deacnption Initial
Repair System Other Factors (.1946y
ilabie 3 ce .1945 stem Site Classification (.1948y /f
Ava
Evaluated By:B/L
Site LTAR
Others Present:
C