IPAC RHTE# C7°1 Harnett County Department of Public Health 2 5 6 9 5
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: Hwyai--) W
ISSUED TO: SUBDIVISION 77n+6E,,, Qnx LOT # -7 -7
NEW REPAIR ❑ ANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: S C-' (Lk<; -n 'A 5~-
Proposed Wastewater System Type: Qu ne`Td °~n t G~ o N Sy~sE,
Projected Daily Flow: 3to GPD
Number of bedrooms: 3 Number of Occupants: max
Basement ❑Yes ',~<No
Pump Required-."Tgxes ❑ No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community X Public ❑ Well Distance from well ~0(y feet Permit valid for Five years
Permit conditions: ❑ No expiration
Authorized State Agent:: Date: 4 \-4o SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the ce of other permits. The permit holde 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 Impr ement 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: ~.FSMPROPERTY LOCATION:
S~ x SUBDIVISION `'~t•$cetJ ied 'J1E,' LOT #
Facility Type: Y1 J ['xNew ❑ Expansion ❑ Repair
Basement? ❑ Yes --N No Basement Fixture? ❑ Yes XNo
Type of Wastewater System** P Vrn~`Sd 2~ ~L0 ,ZFDucx ps S SsG-sn (Initial) Wastewater Flow: d GPD
(See note below, if applicable
?y in i70 Ce tv , w PQ aItP.'S cep (Repair)
Installation Requirements/Conditions Number of trenches
Septic Tank Size S 0Q>Q gallons
Pump Tank Size L 00 Q gallons
Pump Requirements: ft. TDH vs.
Exact length of each trench 2i0 feet
Trenches shall be installed on contour at a
Maximum Trench Depth of: 11 inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
GPM
Trench Spacing: Feet on Center
Soil (over: G inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
inches below pipe
Aggregate Depth: inches above pipe
Conditions: ~H~ ~FAr st ~O N QaotosAt ~-aot•, ~eeL•cp,•Jt L,5s WAS. L'*A 1'v55 li, c inches total
10 i ~ r~ SF.,PC~G S7' S ~.M N o 1,} T a L ~^C 1{S, n " r1A C5Ld D[}A 0 14 kN q L OC... RCM1Z~
**If applicable: /understand the system type specified is different from the type specified on the app/icmion. / accept the specibcationr of this permit.
Owner/Legal Representative Signature: Date:
This Construction Authorization is subject to re`vdtatt i d the site Ian, 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 Authorizat`ion,j to complian ith the s he Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent: v \r ~1 jS Date: _
Con tion Authorization Expiration Date:
HTE# Cn --5 Permit #
narnett County Depwlment of '>libl is Health
Site Sketch
a,1 W
PROPERTY LOCATON: Hw-i
ISSUED TO: Ar, 2 ~c A r e \-,;NA SUBDIVISION -Tt,< ParssE LOT # -7
Authorized State Agent: aS ~s vUtw ourxoo Date: O-
o
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Division of Environmental Health Property ID:
On-site Wastewater Section Lot #
File tt
SOILiSITE EVALUATION Code:
for ON-SITE WASTEWATER SYSTEM
Owner: Applicant:
Address: Date Evaluated:
Proposed Facility: (b -4n,, Ntjs Design Flow (.1949): Property Size:
Location of Site:
Property Recorded:
Water Supply: Public (J Individual [ j Well Spring
Evaluation Method: uger Boring [ j Pit Cut
Type of Wastewater. ( ewage Industrial Process (J Mixed
R
o
SOIL MORPHOLOGY
OTHER
F
•1941
PROFILE FACTORS
1
.1940
1942
L
Landscape
Horizon
.1941
.1941
So#
.1943
1980
.19"
E
PoaftW
Depth
Structure/
Conalsbrics
Webmpallt
Sol
Sol"
Re*l
0
S %
(IN.)
I Texture
color
q~,)
Class
Elora
see- X,z_
F" 5S)gC
TZJC'
~7"
G L~j
'VFn t r~
Description
Initial System
,Repair System
Other Factors (.1946):
Available Space (.1945)
Site Classification (.1948):
System Ty e(s)
P~ ~K P ~~Q
Evaluated By:
91~
Site LTAR
• 44
Others Present:
t'tl G
[ I Other
LTAII
S