IPACHTE# I;-:- z3z Harnett County Department of Public Health 25701
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: S'-
ISSUED Tq~ LeI>A SUBDIVISION LOT # /
NEW REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: 7,~c,!r --S 77hy h (wltTif ~ljT//SLASj
Proposed Wastewater System Type: C'bAh.~
Projected Daily Flow: / Do GPD
Number of bedrooms: Number of Occupants: max
Basement ❑Yes [?"No
Pump Required: ❑Yes ❑ No 2 Maye required based on final location and elevations of facilities
Type of Water Supply: ❑ Community L Public F-1 Well Distance from well feet Permit valid for. Z Five years
Permit conditions: ❑ No expiration
Authorized State Age t:: A Date: /Z - 0e, SEE ATTACHED SITE SKETCH
The issuance of this permit by a e
site alth 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
is subject to revocati on if a 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, .195S, .1956, .1951, .195& 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: ZZOA) -S7U f PROPERTY LOCATION:
i3 SUBDIVISION LOT # I_
Facility Type: New ❑ Expansion ❑ Repair
Basement? ❑ Yes ❑ No Basement Fixtures? El s El No
Type of Wastewater System** ~~t)P~JY"t.al (Initial) Wastewater Flow: GPD
(See note below, if applicable
0~y qt [r (Repair)
Installation Requirements/Conditions Number of trenches Z
Septic Tank Size /0410 gallons Exact length of each trench 5 $ feet
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
Pump Requirements: It TDH vs. GPM
Conditions:
Trench Spacing: 9 Feet on Center
Soil Cover: ! inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
6 inches below pipe
Aggregate Depth: Z inches above pipe
/ Z inches total
**If applicable: / understand the system type specified is different from the type specified on the app&.Ivon. / accept the specifications of this permit
Owner/Legal Representative Signature: Date:
This Construction Authorization is subiect to rrvoratinn if thr cite nlan nlat nr rho intondod - A- , Th. r--t;- .h,u
e _ 6 -...-F
Construction Authorization is subject to compliance 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 Age
IgDate: //-/L :06L
Construction Authorization Expiration Date: I j -1Z -/410
HTE# Z9q - S - Z3Zd ~ Permit # Z S-7 6 l
Harnett ('aunty Department of Public Health
Site Sketch
PROPERTY LOCATON: 4zL7 . " S5~
ISSUED TO: LCIJ o SUBDIVISION LEd7J .~irt.z J~ LOT #
Authorized State Agent: Date: //-IZ-v Y
c ~iylp~
;n
Qb~
I~
T•►~C- l'V~X T
Tb Z) gax
7e)
cj~
306' .41- 1/- 5 6sr j
cis e-- Nwy sy,
Department of Envimnmenk Health and Natural Resources Shed:
Division of Environmental Health Property ID:
On-Site Wastewater Section Lot
File
SOBJSITE EVALUATION Code:
for ON-SITE WASTEWATER SYSTEM /
Zb~ j lt-A
Owner: Applicant: Z3 J
Address: Date Evaluated: size:
Proposed Facility: Design Flow (.1949): Property
Location of Site: tu Property Recorded:
Water Supply: I Individual [I Well C1 Spring C] Other
Evahlatlon Method: L~J g:er B o rg ❑ Pit ❑ cut
Type of wastewater. D-fewap ❑ Industrial Pty ❑ Mixed
P
R
O
F
1
940
OIL MORPHOLOGY
.1941
OTHER
PROFILE FACTORS
L
E
#
.
Lasmimpe
Position/
Slope %
Horizon
Depth
(in.)
.1941
structural
Testun
.1941
Consistence
mumalo
1941
soil
Wept
Color
.1943
soil
Depth (IN.)
.1936
Sapro
Class
.1944
Restr
Horiz
Profile
Class
3 LTAR
L 770
o Lv
SL
tic. GfS~
sx, C."41
P. 09C
2.
L7~,~
b-tY
SL.
tic. (Sn/'`~f
- f6
Description
Dial
s ern
Repair Sy
Other Factors (.1946
site classification (.194sr F S
Available S 1947
Evahmted By:
Svdam Type(s)
Odm Present:
Site LTAR
t
14