IPACHTE# Q''1 a3a~5 Harnett County Department of Public Health 2 5 7 7 8
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: At..E'sry - 4th
ISSUED TO: $ LF-. C.1_t_ O r~ 6_-, SUBDIVISION 7-H6 Sv rv-N tr, n LOT #
NEW, REPAIR ❑ XPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: G~- V Q8 r- ' 5
Proposed Wastewater System Type: C-~a N-j Errc\or j;"AL-
Projected Daily Flow: 34-o GIRD
Number of bedrooms: 3 Number of Occupants: max
Basement ❑Yes No
Pump Required: ❑Yes 'KNo ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community `;K, Public ❑ Well Distance from well t (Z~ feet Permit valid for. ,Five years
Permit conditions: ❑ No expiration
Authorized State Agent:: 'ry 9Q-\1AA _ Date: <7 SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the ' of other permits. The permit holder is respo sible 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 Impro ent 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 T0: $i ac-~c-w 1 ~o rho PROPERTY LOCATION:
SUBDIVISION -V"c- S tin, ~-C LOT # _N
Facility Type: New ❑ Expansion ❑ Repair
Basement? ❑ Yes X No Basement Fixtures? ❑ Yes No
Type of Wastewater System** Co~.v ~larvp,L (Initial) Wastewater Flow: 3~6 GPD
(See note below, if applicable
C,oa r4 P,L~ (Repair)
Installation Requirements/Conditions Number of trenches a
Septic Tank Size 1 O o O gallons Exact length of each trench ' l S feet
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of: a*4 -30 inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
Pump Requirements: ft. TDH vs. GPM
Conditions: \,1 N7 Ere, L\Ne_'vsc ~E ~0 Vao" SE:-e'v)C- SryS.T-G"\
Trench Spacing: Feet on Center
Soil Cover 1x'18 inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
CI inches below pipe
Aggregate Depth: inches above pipe
1? inches total
**If applicable: /understand the system type specified is different from the type specified on the application. / accept the specillca Ws of this permit
Owner/Legal Representative Si nature: Date:
This Construction Authorization is subject to revo it the si Ian, 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 subje~t compliance t " ns a laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent: A~~~ ( s Date: ti t'Cons ction Authorization Expiration Date: 4
HTE# OC1-~` a.&- ,S5
Permit # a5-7
Harnett Connty Department of M blic Health
Site Sketch
PROPERTY LOCATON: L,P I N E
ISSUED TO: ~L^ l.. F.t t., Orn Es SUBDIVISION i t~L Sv LOT # `1`3
Authorized State Agent: 61-1,46Q `Sa~XSao Date: 4`~
pv,qjNF J)",
50'
»-7 I/
Department of Environment, Health and Natural Resources
Division of Environmental Health
On-Site Wastewater Section
SOI [JSITE EVALUATION
for ON-SITE WASTEWATER SYSTEM
Owner: Applicant:
Address: Date Evaluatod:
proposed Facility,:3 Design Flow (.1949):34-c5-~5c
Location of Site: Property Recorded:
Water Supply Public ❑ Individual ❑ Well
Evaluation Method Auger Boring ❑ Pit ❑
Type of Wastewater 'rySewage ❑ Industrial Process ❑
Sheet:
Property ID:
Lot
File
Code:
Property Size:
❑ Spring ❑ Other
Cut
Nfixed
P
R
O
F
I
940
OIL MORPHOLOGY
.1941
THER
PROFILE FACTORS
L
E
0
.
LoWeoape
Position/
Slope %
Haim
Depth
(ln.)
.1941
Shummow
Team
.1941
Con"moe
Minmalo
.1941
Soil
Wd11WW
Color
.1943
Soil
Do* MC.)
.1936
sm"
Clm
.1944
Restr
Honer
Proms
Cim
A LTAR
s
a ~o
Q-~
~ s
~~,.JSI~
S
Desaiptioo
11"
s
Repsv System
Other Factors (.1946
Site classification (.194ar 7,
Ava&Mo Spam .1943
Evahated By: O'S
Sydow Type( s
C-0 a
CU N
Others Present: -
Site LTAR
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