IPACHTE# 0 s = z3 10-f Harnett County Department of Public Health 2 5 6 4 6
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
( PROPERTY LOCATION: /If A " cr-' 'ka
ISSUED TO: v t1~J SUBDIVISION ~ t;,M r- LOT #
NEW [ < REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: SP 0 j y(,
Proposed Wastewater System Type: r1f'T6 ,,Q ectv_c.j=c,L Ste,
Projected Daily Flow: (o O GPD
Number of bedrooms: Number of Occupants: max
Basement ❑Yes F N0
Pump Required: ❑Yes ❑ No f?"Maa be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community L~J Public ❑ Well Distance from well feet Permit valid for. P'tne years
Permit conditions:
❑ No expiration
Authorized State Agent: C Date: 4 bets SEE ATTACHED SITE SKETCH
_ZZ The issuance of this permit by Health Department in no way guarantees the issuance of other permits. 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 TO: Cv"-J~~- W11-
PROPERTY LOCATION: ~,tJ cr-ol~ ,(',t',
SUBDIVISION ~r% ' J~r,,rc„f LOT # 2 2
Facility Type: r-EP Q'-New ❑ Expansion ❑ Repair
Basement? ❑ Yes No Basement Fixtures? ❑ Yes ❑ No
Type of Wastewater System" a s- Y. eA' e.J (Initial) Wastewater Flow: GPD
(See note below, if applicable
air- e"-4~t"-r (Repair)
Installation Requirements/Conditions Number of trenches S"
Septic Tank Size Qt, 0 gallons Exact length of each -trench feet
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of. / Z-? inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
Pump Requirements: ft. TDN vs. GPM
Trench Spacing: Feet on Center
Soil Cover: °!2 inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
Conditions: /a
, , ~.y per _
inches below pipe
tte Depth: inches above pipe
inches total
**If applicable: / understand the system type specifed is different from the type specified on the appliwion. /accept the specilcationr of this permit
Owner/Legal Representative Signature: Date:
This Construction Authorization is subject to revocation if the site plan, plat, or Lite intended use changes. The Construction Authorization shall not be transferred when there is a change in ownership of the site. This
Construction Authorization is subject to dance with the provisions of the laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agep~,, C f Date: V~ ~Qc
~ Construction Authorization Expiration Date: /i Vv,~e
HTE# -0 aJi'~`1
Permit # Z 5- ( `4
Harnett County Deptilment of Viblic Heald,
Site Sketch
PROPERTY LOCATON: opt J'~r
ISSUED TO: Asap Q- "-O tA c - SUBDIVISION 1;,.a 2c roc~~ LOT # --99_
Authorized State Agen 1(v f Date: Z ~o f
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Department of EmAro t, Health and Natural Resources Sheet:
Division of Envkomnmtal Health
On-Site Wastewater Section Property ID:
Lot
SOILISITE EVALUATION File
for ON-SITE WASTEWATER SYSTEM Cam'
Owner. Applicant:
Address: Date Evaluated: it t z-
Proposed Facility: Design Flow (.1949): Property Size:
Loption of Site: Pam, Recorded:
Water Supply. c ❑ ladividual ❑ Well ❑ Spring ❑ Other
Evah>at{on Method: S~ugxerBoring ❑ Pit ❑ Celt
~'ype of Wastewater ese"P ❑ hidust ial Process ❑ eked
P
R
O
F SOUL MORPHOLOGY
1 .1940 .1941
L Horizon
E Poritiont Depth .1941 .1941
* Slope % (la) shucharef Cooeieteooe
TOO" Mioenlo
ic,
Soil 1943
wdnaw Soil
7`-- Site Classification (.1948r of
d t" d
rsOt present-
1956
.1944 Proms
Restr CIS
Horiz & LTAR
X11 ` S-
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