IPACHTE# cnHarnett County Department of Public Health 2 5 7 7 9
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: N -P -N 6 flQ,\,JC
ISSUED TO: BLAC~`~-~.1E1-~- \Apmt_5 SUBDIVISION 5vcr,r-,cC LOT 9_
NEW REPAIR ~l PANSION 11 Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: SF~(_Lk; xs3
Proposed Wastewater System Type: Co~+v~.Siyor►p.l-
Projected Daily Flow: GPD
Number of bedrooms: '2> 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 '5~ Public ❑ Well Distance from well 10(:!) feet Permit valid for. Five years
Permit conditions: ❑ No expiration
Authorized State Agent:: Date: @LA 00~ SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the issu other permits. The permit holde~ 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 Improver tt 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: ~>✓~`G-~ \rme5 PROPERTY LOCATION: E ~2.\VE
SUBDIVISION -I'l-NG 5 u ,,rn X1 LOT # 9 9
Facility Type: New ❑ Expansion ❑ Repair
Basement? ❑ Yes No Basement Fixtures? ❑ Yes -'X-.No
Type of Wastewater System" C_Zr 4,J 61-r" ~,a r4 i>.1_
(See note below, if applicable
Co"'y X10 N N L- (Repair)
Installation Requirements/Conditions Number of trenches a
Septic Tank Size t o O 0 gallons Exact length of each trench 15
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of: '-)JA-30
(Trench bottoms shall be level to +/-1/4"
in all directions)
Pump Requirements: ft. TDH vs. GPM
(Initial) Wastewater Flow: 3~0 GPD
feet Trench Spacing: Feet on Center
Soil Cover: Aa-l$ inches
inches (Maximum soil cover shall not exceed
36" above the trench bottom)
r Aggregate Depth:
Conditions: W a+c~ 1-~^rC MUS1 9-,&- ~O 1 a-O . SEpt~G SyST6m
inches below pipe
inches above pipe
inches total
*H applicable: / anderrtand the system type specified is different from the type specified on the application. / accept the specifications of this permit.
Owner/legal Representative Signature: Date:
2'."... " V,dn, 11,11, t use crian. Ine n shall not be when
in of th site. This
Construction Authorization~is~4kiz complian w h u., ~ isi of theeLaws andeRules for SewagesTr atmenttand~Disposal andtto the conditonstrof this permit there is a changSEEoATTACHED eSITE SKETCH
Authorized State Agent: Q,G»s Date: ~L4
Authorization Expiration Date: s" S
H T E # D30-5 (c, Permit # &517 9
Harnett (county Department of l'~lblic Health
Site Sketch
PROPERTY LOCATON: P\ Le) lv E Q 2N4 C
ISSUED TO: i~ L~ A-v4 L A AO MES SUBDIVISION -7-v,~ 5 ~ . ~ N LOT # g9
Authorized State Agent: t21;t3s bL~ - `SotK5O0 Date: 1 azi' ~1
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Department of Environment, Health and Natural Resources
Division of Environmental Health
On-Site Wastewater Section
SOIIJSITE EVALUATION
for ON-SITE WASTEWATER SYSTEM
owner: Applicant:
Address: Date Evaluated:
proposed Facility: 3 BC~arDesiSn Flow (.1949): 364
Location of Site: Property Recorded:
Water supply: ❑ public ❑ Individual ❑ Well
Evaluadon Method: ❑ Auger Boring ❑ Fit ❑
Type of wastewater. ❑ Sewage ❑ Industrial Pro= ❑
Shed:
Property ID:
Lot
File
Code:
property Size:
❑ Spring ❑ Other
cut
Infixed
P
R
O
F
I
940
OEL MORPHOLOGY
.1941
THER
PROFILE FACTORS
L
E
#
.
Landscape
Position/
slope %
Horizon
Depth
(In.)
.1941
strvcojd
Texhre
.1941
Comistame
mineralogy
.1941
soil
Wad
Color
.1943
Soil
.1956
sago
Clan
.1944
Reelr
Hann
Proms
Class
& LIAR
i
L5
3°l~
Cy
11
a~
S
11Ri N
SA
Ueaaiptioe
Initial
s st
Repair System
Other Factors (.1946):
Site Classification (.1948r 5
Available s 1943
Evalated By: u-,\
Type(s)
~-j
~tl
cV N
Others Presort:
Site LTAIt
• Q
-