IPACHTE# a~ s- k/I Harnett County Department of Public Health 25801
Improvement Permit
A building permit cannot be issued with only an Improvement Permit p
PROPERTY LOCATION:.SX fSy2- C~ (cf spu : k
ISSUED T0: J e- SUBDIVISION LOT #
NEW REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: S 7' Q y~1C
Proposed Wastewater System Type: C Q& a
Projected Daily Flow:. GPD
Number of bedro ms: ~J Number of Occupants: max
Basement Oes ❑ No
Pump Required: ❑Yes ❑ No P /May be required bas on final location and elevations d facilities
Type of Water Supply: ❑ Community ❑ Public Ei"Well Distance from well /0 V feet Permit valid for: ff Ftve years
Permit conditions: ❑ No expiration
Authorized State Agent:: (%~ra~--_ / l)'vsc~;p C~~(f Date: / Zeci` SEE ATTACHED SITE SKETCH
The issuance of this permit by a Ilealthtlr Department io 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:, J7.-e 4.a~c4 PROPERTY LOCATION: CIV ,i5vi ei rye ,e J.
Facility Type: ric-0 P~ew
Basement? Yes ❑ No Basement Fixtures? [9 Ye
Type of Wastewater System** Cr c,%Lfc- . f,`%: -
(See note below, if applicable
Installation Requirements/(onditions
Septic Tank Size /()00 gallons
Pump Tank Size LOM gallons
Ae~4e 11
Pump Requirements: ft. TDH vs.
riditions:7
t r< 9.U".-e 4, A.
SUBDIVISION LOT #
❑ Expansion ❑ Repair
❑ No
r)
Number of trenches ~Z
Exact length of each trench /00 feet
Trenches shall be installed on contour at a
Maximum Trench Depth of. /t9 -0 inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
GPM
C~/-cr,.-r~ ~ ~ Cwt ✓lU1" .~e c,.~ t~ccf
~il~~ f~ A, 4- c., f-reov.),
(Initial) Wastewater Flow: OC d GPD
Trench Spacing: ~ Feet on Center
Soil Cover: (2- /8 inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
r
inches below pipe
e Depth: inches above pipe
w• fl / inches total
cr I " "r At u 4e- ~ - , -r
1 If applicable: / understand the system type rpeciled is different from the type rpeciled on the app/ication. / accept the .rpeci6cationr of this permit.
Owner/Legal Representative Signature: Date:
This Construction Authorization 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 Autnonzatton is sublea to compliance with the provisions of the taws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent: Date: e c
Construction Authorization Expiration Date: /i°l
NTE# 09 -S=vl3 k(li Permit # 02 r f
Harnett County I)epartment of Public Health
Site Sketch
/ PROPERTY LOCATON: q, ISSUED T0: 0 6~ t~q SUBDIVISION LOT #
Authorized State Ager
Date: //k~co 5
77' Zr--
uepartmem ul alvuunnlenl, r7VdJ111, d11U NcItUldl Mt:bUU111eb
Division of Environmental Health
On-site Wastewater Section
SOILiSITE EVALUATION
for OBI-SITE WASTEWATER SYSTEM
Owner:
Address:
Proposed Facility:
Location of Site:
Water Supply:
Evaluation Method:
Type of Wastewater'.
Design Flow (.1949):
(J Public [ J Individual
( ) Auger Boring
( J Sewage
JI lee 1.
Property ID:
Lot
File
Code:
Applicant:
Date Evaluated:
Property Size:
Property Recorded:
ell
Spring
[ J Pit
[ ] Cut
[ J Industrial Process
[ ] Mixed
[ J Other
P
R
O
F
SOIL MORPHOLOGY
.1941
OTHER
PROFILE FACTORS
1
L
E
#
.1940
Landscape
Position/
Slope%
Horizon
Depth
IN.)
1941
Structurot
Texture
.1941
Consistence
Mineraloogy
.1942
Sol
Wetness!"
Color
.1943
SON ,
Depth (IN.)
-'.i956
Sapro '
Class
' ..194
Rest
Horn
Profile ;
Class
& LTAR
G- f 4_5~
V F-r-
7c~
G &J-
L~ ty
V- ~J
r
Description
initial System
Repair System
Available Space (.1945)
System Type(s)
C G w
Site LTAR
Other Factors (.1946):
Site Classification (.1948): ~j
Evaluated By:
Others Present: a 1 -~'tj
~A l, r-)