IPACHTE# c-~o► Harnett County Department of Public Health 2 5 6 9 7
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: PotatSS~pgp,
ISSUED TO: SAM G5 day SUBDIVISION LOT #
NEW REPAIR ❑ PANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: 5 F"fl ( Proposed Wastewater System Type: Co ",j Et- S 1 c, PL
Projected Daily Flow: Co~hb GPD
Number of bedrooms: 5 Number of Occupants: % O max
Basement ❑Yes X No
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 \ Cta feet Permit valid for. 'Five years
Permit conditions: ` ❑ No expiration
Authorized State Agent.: Date: 10~ ►3( Oq SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the iss nce of other permits. The permit holder is re ponsible 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: PROPERTY LOCATION: Po N c> szyt~p, 94>
SUBDIVISION LOT # a
Facilitv Tvoe: Now F-1 Fvnincinn 1-1 li-;.
Basement? ❑ Yes -54 No Basement Fixtures? ❑ Yes No
Type of Wastewater System** Co N-4 En: ~ v N mil- (Initial) Wastewater Flow: GPD
(See note below, if applicable
Co^r,r £-r-r-, ` ° ty-~ t-- (Repair)
Installation Requirements/Conditions Number of trenches
Septic Tank Size gallons Exact length of each trench x.50 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: 1 $ 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: ~,,b~s E-~N ~ CR J Pi s: I O ~ao(r~~, S t `G Sys o ~ ~ y U ~ i la inches total
M M C Czo P.G~ o N ~n1 s \PJ- O<2- ~P~1CL y~AS .
**If applicable: /understand the system type specified if different from the type specified on the app/ication. / accept the specifmitionr of this permit
Owner/Legal Representative Signature: Date:
This Construction Authorization is suQLct to revocation if the site plan, plat, or the intended use changes. The Construction Authorimtinn shall nnr he rran f-r d wh- thn.. o< .h-. a hm ~f A. . U;.
Construction Authorization is subect to complianc riles isionsXthe laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit. SEE ATTACHED SITE SKETCH
Authorized State Agent: R-Sias Date: t o
Con ruction Authorization Expiration Date: _
HTE# M-5f~30K3 Permit # D-% T7
narnett (,ounty Department of _Mibl i c Health
Site Sketch
PROPERTY LOCATON: ~O~sDE2oSfi V~D
ISSUED TO: SUBDIVISION LOT #
Authorized State Agent:~ R& 01-1vfIL oL Date:
cz~1v£►v~ Id
~LEPA~Q,
U'flLL4`7 ~k
PC u
Department of Environment, Health and Natural Resources Sheet: `
Division of Environmental Health Property ID:
On-Site Wastewater Section Lot
File
SOI JSITE EVALUATION Code:
for ON-SITE WASTEWATER SYSTEM
owner: Applicant:
Address= Date Evaluated:
Property Facility: 5 8txzoc " ~Ir'E~gn flow (.1949):
Location of Site: Property Recorded: Property Size:
Water Supply: Public ❑ Individual ❑ Well ❑ Spring ❑ Other
Evaluation Method: Auger Boring ❑ Pit ❑ Cut
Type of Wastewater Sewage ❑ Industrial Process ❑ Mixed
R
O
F
SOIL MORPHOLOGY
OTHER
I
L
.1940
L
d
.1941
PROFILE FACTORS
E
#
n
~caps
P-4400/
Slope %
Horizon
Depth
(10
)
.1941
shu
k"
.1941
.1941
soil
.1943
.1936
.1944
PMMs
.
c
Teztun
Coewsta we
Mh
l
wetnew
3011
3apw
Rastr
Clan
Wa
o
Cdar
IN.
Clan
Hartz
~ LTA
'
ja a.I
Set CL
VI 5 ) P
'
aL,
C.
z, O ~~ls Q ( S VFTy
S8 14L sC-- ~2 s ]sP i P5
~$u F, S I P ~ a a~ v~
~~1 d d- I 0 ~ 1~^' ~'-tl tJS~ N~
~u ~2 ss 1~ ►a,~~~ 3a T 5
5 G~~ G t^~ vC'~
K cC-L, s51 ~o~~~@ 3 .~t
v
juibbla o0 Luba) Repair system Other Factors (.1946):
S Site Classification (.1948r ?5
3 ce .1943
Evaluated By:
R a Others Present:
Q-,
-7 la0 L5 VRi N~l~~n a x as~o` >
5
c;-ya" g x~~~, s 1 s~