IPACHTE# 04-Y=aa-? X3 Harnett County Department of Public Health 2 5 6 5 0
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
QQ PROPERTY LOCAT N: /I W % tre
ISSUED TO: r4cAc:, L ~ ~c(erj SUBDIVISION . ee~ s4 LOT # M
NEW REPAIR ❑ , EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: F
Q Q
r__ b
Proposed Wastewater System Type: C a u~ r
Projected Daily Flow: t GPD
Number of bedrooms: •3 Number of Occupants: max
Basement ❑Yes ?r"No
Pump Required: ❑Yes ❑ No Play required based on final location and elevations of facilities
Type of Water Supply: ❑ Community Public ❑ Well Distance from well feet Permit valid for. Q"Five years
Permit conditions: ❑ No expiration
Authorized State AgenrDate: jf 1o?01a100 7
SEE ATTACHED SITE SKETCH
The issuance of this permit b e Health Department 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, .1957, .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 LOCAT~ N: :cry o ~•tct~ I~~
SUBDIVISION _ ~a c„J G , t LOT # /77
Facility Type: ~ New ❑ Expansion ❑ Repair
Basement? ❑ Yes CST No Basement Fixtures? Yes ❑ No
Type of Wastewater System** C c"kyc ~--cos (Initial) Wastewater Flow: GPD
(See note below, if applicable
C o n Je ti t (Repair)
Installation Requirements/Conditions Number of trenches 3
Septic Tank Size - gallons Exact length of each trench -5-0 feet
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of. f --Zq inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
Pump Requirements: ft. TDH vs. GPM
ns:_i)er V4_9- -(c;
w ecQ ; sip : c
Trench Spacing: ? Feet on Center
Soil Cover: - /2, inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
Depth:
r
inches below pipe
2 inches above pipe
12- inches total
_j 1L %6r~f.
**If applicable: / understand the system type specified is different from the type specified on the app/ication. / accept the specifications of this permit.
Owner/Legal Representative Signature: Date:
This Construction Authonzation is subject to revocation if the site plan, plat, or the 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 compli ith the provisions of the Laws anpules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent: Date: ~C l
Construction Authorization Expiration Date: C a
HTE# Qg-5-- P-~-71,3 Permit # a2 a 5-(- J--'3
Harnett County Department of Public Health
Site Sketch
PROPERTY IOCATON: • cra I s ~,,;~r ki.
ISSUED T0: ~'E~.~~-r SUBDIVISION c,,r l;AT LOT # /F>
Authorized State Agent: Date:
f
/6G
lGr
~c.vl L
Mr',•~W a zr- ~r-.
uepartment Ul CIIVIIUIUlle111, fledllll, d11U I40tUld111UZUU1l1eS
Division of Environmental Health
On-site Wastewater Section
SOILiSITE EVALUATION
for ON-SITE WASTEWATER SYSTEM
Owner:
Address:
Proposed Facility:
Location of Site:
Water Supply:
Evaluation Method:
Type of Wastewater:
Design Flow (.1949):
[ Public Individual
(l~9uger Boring
[ ) Sewage
JI leet.
Property ID: k
Lot
File
Code:
Applicant: I! 1~,667
Date Evaluated:
Property Size:
Property Recorded:
[ ] Well [ J Spring [ j Other
[ ) Pit (J Cut
[ J Industrial Process [ ] Mixed
P
R
O
F
SOIL MORPHOLOGY
.1941
OTHER
PROFILE FACTORS
1
L
E
#
.1940
Landscape
Position/
Slope%
Horizon
Depth
IN.)
.1941
Structure/
Texture
1941
Consistence
Mineralogy
.1942
Sol
Wetness/'
Color
.1943
SON
Depth (IN.)
.1958
Sapra
Class
.1944"
Restr
Horiz
Profile ,
Class
& LTAR
6,
G. 2 S
AT
f
jZ-
r s,.o
a
G_
f
~.P
1
i
Description
Initial System
pair System
Re
Available Space (.1945)
/
f
System Type(s)
Site LTAR
Other Factors (.1946):
Site Classification (.1948):F
Evaluated By:p
Others Present: " I