IPACHTE#
Harnett County Department of Public Health 2 5 8 5 6
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: S bOV Et2- 9--p
ISSUED TO: W M • V a do Q~~ E 1NG• SUBDIVISION 'PFJ.Sl rnr-0r-1 LOT # 5-
NEW,K REPAIR 5PANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: I -,As I
Proposed Wastewater System Type: Pv rn P t ci %-S -/a
.Sys ,
Projected Daily Flow: J"' o GPD
Number of bedrooms: 3 Number of Occupants: max
Basement ❑Yes No
Pump Required: 10Yes ❑ No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community X1 Public ❑ Well Distance from well t4~ feet Permit valid for: ~Eive years
Permit conditions: _ ❑ No expiration
Authorized State Agent.: ~gaa.~te.es The issuance of thi
s permit by the Health Departmet site is subject to revocation if the site plan, plat, or the intended use changes. The Impr
the Laws and Rules for Sewage Treatment and Disposal and to conditions of this permit..
5 Date: ' 1310 SEE ATTACHED SITE SKETCH
of other permits. The permit holder is r ponsible for checking with appropriate governing bodies in meeting their requirements. This
*ement 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, 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: WM. V&,, PROPERTY LOCATION: "00VG_2 (~'D
SUBDIVISION Proms 1t ~M o L,, LOT # S L-1
Facility Type: S~fl ~31~nS't'~ New ❑ Expansion ❑ Repair
Basement? ❑ Yes No Basement Fixtures? ❑ Yes X No
Type of Wastewater System** Putrf 7 o ~O~o 62 Esp. `011,- w~ 9c,Esw2f- NP,NF-+V (Initial) Wastewater Flow: NCO GPD
(See note below, if applicable
L Ve /Ranairl
Installation Requirements/Conditions
Septic Tank Size l cod gallons
Pump Tank Size X- CC (7) gallons
Pump Requirements: ft. TDH vs. _
Conditions: Sr-r- S Ta ~ 'Cott- L.
O E.51 '-J g-y Pw
s---r-••r 300#
Number of trenches 5 `PO SAL
Exact length of each trench v w21 o 0-5 feet
Trenches shall be installed on contour at a
Maximum Trench Depth of: inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
GPM
C-11as .
Saar, C-0 05U
Trench Spacing: Feet on Center
Soil Cover: inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
~-y- Aggregate Depth:
Ul2L I Y'f J ~p¢'L-O 1 o
> P~lr1l'C O P'S60 0 v 9On P cy- tat
inches below pipe
inches above pipe
inches total
S b t C'0 NS V 1 r4-,
I **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: f
This Construction Authorizationn is o revoatuon 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 subct to complian~ rl"Kns 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: 70
'b obstruction Authorization Expiration Date: 1 13 TS`
HTE# C)°\Permit #
Harnett County Department of Public Health
Site sketch
ISSUED TO:
Authorized State Agent:
PROPERTY LO(ATON:
SUBDIVISION LOT # 'S
You~scxx~ Date: t f )3 ko-
\5C,,
-k
f ~ !
r~
1
Depacbuent of Environment, Health and Natural Resources
Division of Enviromllental Health
On-Site Wastewater Section
SOU JSIITd EVALUATION
for ON-SITE WASTRWATICH SYSTKNI
Owner. Applicant:
Address: Data Evaluated:
Proposed Facility: 310 Design Flow (.1949): 3~
Locadon of Sits Property Recorded:
Water Supply: Public 13 Individual ❑ Well
Evaluation Method: Auger Boring 13 Pit ❑
Type of Wastewater: Sewage ❑ hdustrisi Process
Shed:
Property ID:
Lot
File:
Code:
Property Size:
❑ Spring ❑ Other
cut
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.1941
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