IPAC RHTE# -~=~yQ- Harnett County Department of Public Health 2 5 6 9 6
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION:
ISSUED TO: \Aoont:SM \11A SUBDIVISION Tscy6~t r ~tl\LOT # ~ Z
NEW REPAIR EXPANSI N ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: 5 C= Q yy } _
Proposed Wastewater System Type: Pu-e"I' o dA ucayQ aSyy
Projected Daily Flow: '3C- GPD
Number of bedrooms: 3 Number of Occupants: ~o max
Basement ❑Yes '2~No
Pump Required: Nes ❑ No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community „ZR,, Public ❑ Well Distance from well 'LOO feet Permit valid for: Five years
Permit conditions: ❑ No expiration
Authorized State Agent.: Date: - ~ 4 LA n SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the iss rice of other permits. The permit holpon4le 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: ~trn~a.c.Pc~, t-1ocnE5c~,~(~S PROPERTY LOCATION:
SUBDIVISION -TtNof ,m e, LOT # `7%
Facility Type: `~Ffl '~~~"J X New ❑ Expansion ❑ Repair
Basement? ❑ Yes , No Basement Fixtures? ❑ Yes -b< No
Type of Wastewater System** P0 r-% -V~0 rc~S°Lo P..roUCA\C)a SyST~,~
(Initial) Wastewater Flow: -Co GPD
(See note below, if applicable
cne`~ e Cur~v , w I Pn 6s c~6c.~ch~ty (Repair)
Installation Requirements/Conditions Number of trenches li
Septic Tank Size tick 0 gallons Exact length of each trench a3O
feet Trench Spacing: Feet on (enter
Pump Tank Size t OC)D gallons Trenches shall be installed on contour at a
Soil Cover: inches
Maximum Trench Depth of. 1I
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
t~
Conditions: tvA-5Qer„,.l w.sEcs O ~~Pose,1 y -2ah 1~Peuc~,v~s LAS
Aggregate Depth: inches above pipe
\f1a zNtsL U.4
inches total
Y~,,St e W#E-0 -n N -n ~Ncxw Ac,, o ~ ~t4 ,-1 ,QL. M. Qep fa~n
**If applicable: /understand the rystem type speclAed /s different from the type speci>red on the application. / accept the speciAwions of this permit.
Owner/legal Representative Signature: Date:
This Construction Authorization is subject to revocaLon if the site plan, plat, or the intended use changes. The Construction Authnmanoo <h~n oar hn
_ .......b. ............Y .
Construction Authorization is sect to compliance isi!t'f the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent: :y~_ , S 9 0~s Date: t o
Authorization Expiration Date:
HTE# C>°~-536yC~ Permit #
Harnett County Department of 'uw is nealth
Site Sketch
PROPERTY LO(ATON: S-Ir, ~y a_1`rt
ISSUED TO: `A0 SUBDIVISION-\ LOT #
Authorized State Agent: -~~s C~w~ `SCh xs~JO Date: 10,1
t _1
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Division of Environmental Health Property ID:
On-site Wastewater Section Lot #
File ati:
SOILiSITE EVALUATION Code:
for 0,N-SITE WASTEWATER SYSTEM
Owner: Applicant:
Address:
Proposed Facility: ; 0 C-syzoo m Design Flow (.1949): 3 6 (7~
Location of Site:
Water Supply: (I ubllc Individual (j Well
Evaluation Method: ;Pt~uger Boring O Pit
Type of Wastewater. -{Sewage Industrial Process
R
o
SOIL MORPHOLOGY
F
.1941
1
.1940
L
Landscapo
Horizon
.1941
.1941
E
Position/
Depth
Structure/
Consbhw c,
0
S k"%
(IN.)
I Texture
mineralblN
I
Z 5
!
~ks~
G~ cs~se
Description Initial S tern Repair System
Available Space (.1945)
System Type(s) K %J f-*%Y CA r4
Site LTAR •
Date Evaluated:
Property Size:
Property Recorded:
(J Spring
Cut
( J Mixed
OTHER
PROFILE FAC'
.1942
Sol .1943
Webmwe son
Color ' Oaeth to
Other Factors (.1946):
Site Classification 1048): C5
Evaluated ByCq \
Others Present: CN C✓
I I Other
PS
.y5
. i 9u .194'
SWU t Re*