IPACHTE# Harnett County Department of Public Health 2 5 7 7 5
Improvement Permit
A building permit cannot be issued with only Improvement Permit
PROPERTY LOCATION: QOKX4 Kati tJ S5Q_
ISSUED T0: F F P~c~~y ~O SUBDIVISION LOT #
NEW'A REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: M S-S- .AAor'c ~111~x-14
Proposed Wastewater System Type: Co - J E N-~ ,or n,t
Projected Daily Flow: 360 GPD
Number of bedrooms: `5 Number of Occupants: max
Basement ❑Yes X No
Pump Required: ❑Yes -~K No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community Public ❑ Well Distance from well n feet Permit valid for. Five years
Permit conditions: ❑ No expiration
Authorized State Agent:: _
The issuance of this permit by the Health Department in no way guarantees ss ce
site is subject to revocation if the site plan, plat, or the intended use changes. The
the Laws and Rules for Sewage Treatment and Disposal and to conditions of this permit.
ss Date: \)11310~ SEE ATTACHED SITE SKETCH
of other permits. The permit holder respo Bible for checking with appropriate governing bodies in meeting their requirements. This
\tnent Permit shall not be affected by a change in ownership of the site. This permit is subject to compliance with the provisions of
Construction Authorization
(Required for Building Permit)
The construction and installation requirements of Rules .1950, .1957, 1954, .1955, AM, .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 TO: PROPERTY LOCATION:
t~awfly S~rvPNN~
SUBDIVISION LOT #
Facility Type:gj . ~om~~\y x1C~ New ❑ Expansion ❑ Repair
Basement? ❑ Yes No Basement Fixtures? ❑ Yes ~k No
Type of Wastewater System" Co vE-Ji\ U N A L_ (Initial) Wastewater Flow: 3~ 4 GPD
(See note below, if applicable
Co 1% 0 rr K (Repair)
Installation Requirements/Conditions Number of trenches 3
Septic Tank Size t0 O o gallons Exact length of each trench ~D O feet
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of: 1~ inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
Pump Requirements: ft. TON vs. GPM
Trench Spacing: Feet on Center
Soil Cover: C inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
Conditions: A~6a l.__l cc- bus `~C S ,GCj~~;~~c,. No ►L~~s~S
~r C.l + dr IN ~S sAl, O(L q~cL ~ic- PC-- Onv-- 00
inches below pipe
Depth: inches above pipe
I l~ inches total
Motes S vCi7 w I
5C-VA Bb P,p-~--
I **If applicable: /understand the system type specified is dih`erent from the type speciped on the application. / accept the specifications of this permit.
Owner/legal Representative Sig Date:
This Construction Authorization is subject to revocation if I , fat, 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 s to compliance t v e and Rules for Sewage Treatment and Disposal and to the conditions of this permit. SEE ATTACHED SITE SKETCH
Authorized State Agent: Date: i~ z3
Construc ' Authorization Expiration Date: > >
HTE # CD --5= a--tk-~N
Permit # aST7S
Harnett County Department of Public Health
Site Sketch
PROPERTY LOCATON: ~sto~Ow~y
ISSUED T0: 1 , -Rr SUBDIVISION LOT #
Authorized State Agent: Date:
1 OL`F-3 O
3-CS
Department of Environment, Health and Natural Resources
Division of Environmental Health
On-Site Wastewater Section
SOILISITE EVALUATION
for ON-SITE WASTEWATER SYSTEM
Owner. Applicant:
Address: Date Evaluated:
Proposed Facility: Design Flow (.1949):
Location of Site: Property Recorded:
Water Supply: ❑ Public ❑ Individual ❑
Evahmlion Method: ❑ Auger Boring ❑ Pit
Type of Wast3ewater. ❑ Sewage ❑ Industrial Process
Sheet:
Property ID:
Lot
File
Code:
Property Size:
Well ❑ Spring ❑ Other
cut
❑ Mixed
P
R
O
F
1
940
OIL MORPHOLOGY
.1941
THER
PROFILE FACTORS
L
E
#
.
L.mdmpe
Potation/
slope %
Horizon
Depth
(In.)
.1941
Sbucturw
Taxwo
.1941
Conaletena
Mineralogy
.1941
soil
Weln"d
Cola
.1943
god
Depth IN.
.1936
Sego
Clan
.1944
Re*
Horiz
Profile
Class
A LIAR
SL
C
~~0
~a
I
I
i
Description
Italia!
Systern
Repair Syotem
Other Factors (.1946):
Site Classification (.1948y
Available Space .1943
Evaluated By:
e
Others Present:
Site LTAR