IPACHTE# O`1--5a51 Harnett County Department of Public Health 2 5 6 0 0
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
1 PROPERTY LOCATION: P. fl
ISSUED TO: w~+tYN ~ra~~a.vL~,o„t SUBDIVISION P,otvT-GZr•
NEW; REPAIR,CJ _ LOT ~
EAHSION El Site Improvements required prior to Construction Authorization Issuance: :
Type of Structure: S Q'O Lk U ,x LA C'
Proposed Wastewater System Type: RFC 0---)
Projected Daily Flow: 3CaU GPD
Number of bedrooms: Number of Occupants: max
Basement ❑Yes No
Pump Required: ❑Yes l56o ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community X Public ❑ Well Distance from well \ CEO feet
Permit valid for. Five years
Permit conditions:
❑ No expiration
Authorized State Agent : Date: I t SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health r no war guar of other permits. The permit holder is for checking with appropriate governing bodies in meeting their requirements. This
site is subject to revocation if site plan, plat, or the intended use 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 le ,t and Disposal and to conditions of this permit.
Cots 7c an Aua;horintion
(Required for Building Permit)
The construction and installation requirements of Rules 1950. .1952, .1954, .1955, 1956, .1957, .1958. and .1959 are incorporated by references
with the attached s
stem la
out
into this permit and shall be met. Systems shall be installed in acco
d
y
y
.
r
ance
ISSUED T0:
PROPERTY LOCATION: _ 1
cs~G~c
r SUBDIVISION P, nN &P -Q-
Facility Type: S~p(:AO-4S---_
New ❑ E
LOT # _
xpansion ❑ Repair
Repair
Basement? ❑ Yes %X No Basement Fixtures? ❑ Yes >-1\No
Type of Wastewater System" °Z) R E"D V QG' \ U N S ~ 5-s ~M
(Initial) Wastewater Flow: (7~) GPD
(See note below, if applicable
o R[~uLClct>v Syst - (Repair)
Installation Requif fllents/Conditions Number of tienrh,s =
Septic Tank Size L ooa gallons Exact of feet
Pump Tank Size
ll
Ttenrh Spacing: feet on Center
ga
ons T _ic nes shall hr inst ,!Ter on at a
Soil cover 1 a
inches
Maximum Trench Depth of. Q~~ 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
Conditions: "14 1 L MQ~ T (3 E 1O cj~-P CIG :5 7E,4)
A regate Depth: inches above pipe
r„
t>_.Sts Mq EctLap,G off 1N~~~R~ o~ Q p,s
c inches total
-If applicable: / undeatdnd the fyftem type fpeciled if different from the type Foeclled on the appllotion.
/ accept the fpecilcationf of this permit
Owner/Legal Representative Signature:
Dater
. 11- d- a :uuleu to revocation it the plat, or the intended use changes. The Construction Au ho ta~ion shall net be t ansferad when there is a charge in awflersht~ of the sire: This
Construction Authorization is subject to complian the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this pe mit SEE ATTACHED SITE SKETCH
,t
NTE# O's `5l
Harnett County
Permit # ~56~0
Depailinent of Public nealth
Site Sketch
PROPERTY LOCATON: k 0coc,)L ~C~
ISSUED TO: W y N N N wC7x to f, SUBDIVISION R o ~ c~ s LOT # $
Authorized State Agent: ,
Q0 t.. 6n. `ta0xsooc~ Date: I~~
(~4.
v P m~
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tbd
Department of Environment, Health and Natural Resources
Division of Environmental Health
On-Site Wastewater Section
SOIIJSTTE EVALUATION
for ON-SITE WASTEWATER SYSTEM
Owner. Applicant: \
Address: Date Evaluated: ~011°1 } `1
Proposed Facility: 3 gam-, E Design Flow (.1949): 3.60 J~
Location of Site: Piny Recorded:
Water Supply: Public p Individual ❑ Well
Evaluation Method: Auger Boring F1 Pit
Type of Wastewater. Sewage p Industrial Process ❑
Sheet:
Property ID:
Lot
File
Code:
Property Size:
❑ Spring p Other
cut
Milted
P
R
O
F
1
L
1940
SOIL. MORPHOLOGY
.1941
OTHER
PROFILE FACTORS
E
S
I.adspe
Position/
slope %
~S
Horizon
Depth
(tn.)
.1941
Struck"
Texh"
.1941
Consistence
Mhw*io
.1942
Soil
we4leal
Color
.1943
sod
Depth IN.
.1936
SWO
Clue
.1944
Rao
Horiz
Profile
Claw
& LTAR
G
vl~P
R System Other Factors (.1946
Description Ih-.5
System
Site Classification (.1948y 4
Available Space .1943 ' Q / y~Evaluated By: 4 V
Pt se t:
Site LTAR 3