IPACHTE#-Q)': -23355
Harnett County Department of Public Health 2 5 8 5 7
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: Nr-a-%0.5
ISSUED T0: 1i M~LC OEss \AL. C owS< . SUBDIVISION ',4 op pS LOT # 5
NEW X REPAIR ❑ EXPAN3IQN ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: S C~ ~S ~SS~
Proposed Wastewater System Type: QU WO a ~aS'4a ~6cJ , SNg ,
Projected Daily Flow: GPD
Number of bedrooms: Number of Occupants: max
Basement ❑Yes X No
Pump Required:Aes ❑ No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ CommunityI Public ❑ Well Distance from well LSO feet Permit valid for, Five years
Permit conditions:. ❑ No expiration
Authorized State Agent::Date: A 1~ 1 SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the issuan of other permits. The permit holder 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 Improvement 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, .1951, .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:T~+GS ~Es,OFrn\~,L C-o~sr. PROPERTY LOCATION: NUS
SUBDIVISION BEa 'A 0005 LOT #
Facility Type: SAC s x5~ New ❑ Expansion ❑ Repair
Basement? ❑ Yes No Basement Fixtures? ❑ Yes -X No
Type of Wastewater System** Put-f' 'o c,S Zo 9-COUC.::~113N ~ys~C (Initial) Wastewater Flow: -'D GPD
(See note below, if applicable
P u r' ~o a S°~, Luc, w~ SYS ~r~ (Repair)
Installation Requirements/Conditions Number of trenches 3
Septic Tank Size l noa gallons Exact length of each trench feet Trench Spacing: c1 Feet on Center
Pump Tank Size 1-0 o C3 gallons Trenches shall be installed on contour at a Soil (over: C, inches
Maximum Trench Depth of: ~ Z inches (Maximum soil cover shall not exceed
(Trench bottoms shall be level to +/-1/4" 36" above the trench bottom)
in all directions)
Pump Requirements: ft. TDH vs. GPM inches below pipe
Aggregate Depth: inches above pipe
Conditions: \,f P'T<>a- V LNG-. ~vs> 4~ l0 ~ctc,r~s Seel ,G S,+SSEt•-s inches total
If applicable: /understand the rystem type specified is different from the type specired on the application. / accept the specifications of this permit
Owner/Legal Representative Signature: Date:
This Construction Authorization i to revocation if the 'te 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 subs to complied _ provis 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 13 10
Con ction Authorization Expiration Date: T ~3 1S
HTE# Permit # -,A:~ ~ S-)
Harnett County I)epartnlent of INibl is Health
Site Sketch
_ PROPERTY LO(ATON: NC. 0-!0 '
ISSUED T6- T L Cs~oCll 1 K- C.) SUBDIVISION ' 00 os LOT #
Authorized State Agent: Q E~nS a Lw6n-- oLvQ Vo Date: ~ ► l 0
J
Z
SEN C0 Q C\
ueparnnlenlul GIv11U11111e1I1, rledllll, d11U IVdlUldl r1eSUU1k Ub Jl ltlta.
Division of Environmental Health Property ID:
On-site Wastewater Section Lot
File
SOILiSITE EVALUATION Code
for ON-SITE WASTEWATER SYSTEM
Owner:
Applicant:
Address:
Date Evaluated:
Proposed Facility: ~
EOa c~ ti Design Flow (.1949):366
5~
Property Size:
Location of Site:
+
Property Recorded:
Water Supply:
[Public (J Individual
[ j Well
(j Spring
Evaluation Method:
I-IfAuger Boring
[ J Pit
(J Cut
Type of Wastewater:
[Sewage
(j Industrial Process
(J Mixed
[ j Other
P
R
O
F
SOIL MORPHOLOGY
.1941
OTHER
PROFILE FACTORS
1
L
E
#
.1940
Landscape
Position/
Slope%
Horizon
Depth
(IN.)
1941
Structure/
Texture
.1941
Consistence
Mineralogy
.1942 .
Sol
Wetness/'
Color
.1943
Soli
Depth (IN.)
.1956
Sapra
Class
.1944"
Restr
Horiz
Profile
Class
& LTAR
G ,
Q ~9
G ~
~t F'2 ~ ~V P
P'S
5 ly
1 CA 3' )
"3\4, '5 G-
VC~ 5
'
\j Vs
~
5 5r
~fL 5q~ -5
y
Description
Initial S tem
R pair System
Available Space (.1945)
System Type(s)
°liCthb
Site LTAR
Other Factors (.1946):
Site Classification (.1948): 4V
Evaluated By:"
Others Present:
~ It- n',