IPACH T E # 0, s -I-= &a..~9'i Harnett County Department of Public Health 2 5 6 4 3
Improvement Permit
A building permit cannot be issued with only an Improvement Pe t
PROPERTY LOCATION: -1) h- ~ k 4c
ISSUED TO- ~2ac SUBDIVISION LOT #
NEW Z REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: ,6w r6 d' p
Proposed Wastewater System Type: C aAW'4-;Ur,_-k
Projected Daily Flow: /dc GPD
Number of bedrooms: Number of Occupants: max
Basement ❑Yes ❑ Nom
Pump Required: ❑Yes t No ❑ May be required b ed on final location and elevations of facilities
Type of Water Supply: ❑ Community ❑ Public Well Distance from well /00 feet Permit valid for i2live years
Permit conditions: ❑ No expiration
Authorized State Agent:: Date: ct l '.tae SEE ATTACHED SITE SKETCH
The issuance of this permit by t ealth Department in no way guarantees the issuance of other permitt. 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 T0: PROPERTY LOCATION: 'e(J,
/ SUBDIVISION LOT #
Facility Type: So rA New ❑ Expansion ❑ Repair
Basement? ❑ Yes 2' No Basement Fixtures? ❑~}Yes ❑ No
Type of Wastewater Systern'~ GC)/LV4A~:~.1S (Initial) Wastewater Flow: /00 GPD
(See note below, if applicable
CG.7~eti4 °•ca (Repair)
Installation Requirements/Conditions Number of trenches Z
Septic Tank Size - /000 gallons Exact length of each trench J-0 feet
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of. _t_$ inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
Pump Requirements: ft. TDH vs. GPM
Conditions: vn Ar~•n ~•t%(r GA Co-, wr da S.2L' IF al~n W1.
Trench Spacing: 9 Feet on Center
Soil Cover: 6 inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
C inches below pipe
A~Sregate Depth: inches above pipe
1 inches total
**If applicable: /under understand the rysteIn type specified is different /ram the type specified on the app/ication / accept the speci6cwt nr of this permit.
Owner/Legal Representative Signature: Date:
Thlc -k;- . :1 .
- ° .11 r,o.., ra1 1- „1= uiangna. Mt wnxruaion numonzaoon snau not oe transterrea when there is a change in ownership of the site. This
Construction Authorization is subject to compliance with the provisions of the Lawj and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent: C" l Date: V/ai
-12
Construction Authorization Expiration Date: /q .2 Zo
HTE# Gej _,S- ~A-tbS9 Permit # aS-,
Harnett Connty Department of Public Health
Site Sketch
PROPERTY LOCATON: \ a n~ I~ crm L "j.
ISSUED TO: g. SUBDIVISION LOT #
Authorized State Agent z c/ Date: A/Afflo i.
.r (t
I ~
f- I
Department of Environment, Health and Natural Resources
Division of Environmental Health
On-Site Wastewater Section
SOILISPTE EVALUATION
for ON-SITE WASTEWATER SYSTEM
Owner: Applicant:
Address:
Proposed Facility:
Location of Site:
Water Supply:
Evaluation Method:
Type of Wastewater.
Date Evaluated: I c0 4 1 al
Design Flow (.1949):
Property Recorded: '
❑ Public ❑ Individual Well
uger Boring ❑ Pit ❑
[Sewage ❑ Industrial Process ❑
Sheet:
Property ID:
Lot
File
Code:
Property Size:
❑ Spring ❑ Other
Cut
Mixed
P
R
O
F
I
1940
OIL MORPHOLOGY
.1941
THER
PROFILE FACTORS
L
E
#
Landscape
Position/
slope's
Horizon
Depth
(In.)
.1941
Structure/
Tee hire
.1941
Consistence
Mineralogy
.1942
soil
webmw
Color
.1943
soil
Depth IN.
.1936
Sapro
Class
.1944
Restr
Hord
Profile
Chm
LTAR
Description
initial
s stem
Repair System
Other Factors (.1946):
Site Classification (
1948
Available Space .1941
.
y
n
E
l
t
d B
System lype(s)
c
~ ~ v
va
ua
e
y: i f
O
h
Site LTAR
~ `1
t
ers Present: