IPACHTE# Cf"V x~~a Harnett County Department of Public Health 2 5 7 8 3
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
~i PROPERTY LOCATION: ZeG Cct-LN .a s Q D
ISSUED TO: Poe s o Zs QQsr" Co SUBDIVISION LOT #
NEW REPAIR ❑ EXPANSION ❑
Type of Structure: F . s z • % Laos rr grj S..o e
Proposed Wastewater System Type: C e Nv E d rs o.~
Projected Daily Flow: GPD
Number of bedrooms: Number of Occupants: 4- max
Basement ❑Yes No
Site Improvements required prior to Construction Authorization Issuance:
Pump Required: ❑Yes ;S No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community 'tg Public ❑ Well Distance from well X00 feet Permit valid for. -N Five years
Permit conditions: ❑ No expiration
Authorized State Agent:: ~E~\ Date: s s \301 6'A SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the issuance o er permits. The permit holder is s 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 ermit 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 TO: c~v o o0w L PROPERTY LOCATION: 7S at C-G 5 Rn
SUBDIVISION LOT #
Facility Type: SvvX New ❑ Expansion ❑ Repair
Basement? ❑ Yes "R No Basement Fixtures? ❑ Yes No
Type of Wastewater System" CIO ""r yS c3 L, (Initial) Wastewater Flow: ` o 0 GPD
(See note below, if applicable
CIO H v G r e%.rj N p, t. (Repair)
Installation Requirements/Conditions Number of trenches 2.
Septic Tank Size 0,,,j o gallons Exact length of each trench S o feet
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of: 2-Li inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
Pump Requirements: ft. TDH vs. GPM
Conditions:
Trench Spacing: Feet on Center
Soil Cover a inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
Aggregate Depth:
inches below pipe
inches above pipe
1 inches total
**If applicable: /understand the system type specified is different from the type specified on the application. / accept the specifications 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 Authorization is sublett to compliance w ror of the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent: Date: v~
Authorization Expiration Date:
HTE # O°1--S -a3a-~•
Harnett County
Permit # a.S-7-13
Depa-ulnient of Public Health
Site Sketch
PROPERTY LOCATON: ZoG C ),RNs ~D
ISSUED TO: Av oo N C SUBDIVISION LOT #
Authorized State Agent: ~k£rs Date:
I
!y D ~
Lv
D
A
Z,
5)a"
Department of Environment, Health and Natural Resources
Division of Environmental Health
On-Site Wastewater Section
SOILJSTTE EVALUATION
for ON-SITE WASTEWATER SYSTEM
Owner. Applicant:
Address:
Proposed Facility:
Location of Site:
Water Supply:
Evaluation Method:
Type of Wastewater.
Date Evaluated: \
Design Flow (.1949): Iwo 3c)
Property Recorded-
C1 Public ❑ Individual ❑
❑ Auger Boring ❑ Pit
❑ Sewage ❑ Industrial Process
Shed:
Property ID:
Lot
File
Code:
Property Size:
Well ❑ Spring ❑ Other
0 cut
❑ Mixed
P
R
O
F
1
940
OU. MORPHOLOGY
.1941
OTHER
PROFILE FACTORS
E
0
.
Position/
slope %
Horizon
Depth
(in.)
.1941
Structuaw
Tare
.1941
Consistence
Mineralogy
.1941
soil
we>er~
Color
1943
Sod
Divilt (IN.)
.1936
Sol"
Class
.1944
Res1r
Horiz
clan
clan
LTAR
1
a -~e'~,
O ZNV`
G ~ c..>r
~ 1 ssl Sp
ccL a-Q % N
~ S
Description
initial
s st
System
Other Factors (.1946
Site Classification (.1948r
Available Space .1943
Evvahatedd By:
TYL*
8)
V N
Present:
oft
-
Sit* LIAR
'3~.5
`