IPACH T E # 0cl a.~.°tc a Harnett County Department of Public Health 25861
Improvement Permit
A building permit cannot be issued with only an Improvement permit
OPERTY LOCATION: wy $7 )~,9
ISSUED TO: C ~rv °k~ ~C"c,e acs ~Lsauoe~cE C1Es> BDIVISION LOT #
NEW^ REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: 30535 o[~rcc L ~c~~cE
Proposed Wastewater System Type: CoNV~,rc\devP+t
Projected Daily Flow: foUo, GPD 2 t3a,e~ovBEs
kw&r-eftcdtrtonn: Number of Occupants: X16-'*max
Basement ❑Yes X No
Pump Required: ❑Yes ❑ No X May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community X Public ❑ Well Distance from well 106 feet Permit valid for: X Five years
Permit conditions: ❑ No expiration
Authorized State Agent:: Date_ ► (1 C) SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantee ssuance 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, .1952, 1954, .1955, .1956, .1951, .1958. and .1959 are incorporated by references i
nto this permit and shall be met Systems shall be installed in accordance
with the attached system layout
ISSUED TO: STtS Pry, (~a„a c E 1 ► S i~sx~ PROPERTY LOCATION: Uv1t
~ ~ y
SUBDIVISION
LOT #
Facility Type: 34~`c'r'D~;tp.LOcF~CG New ❑ Expansion ❑ Repair
Basement? ❑ Yes No Basement Fixtures? ❑ Yes 'N. No
Type of Wastewater System** Cow,Je.,,J7 ~ 0 ,411?1 .
(Initial) Wastewater Flow: brig GPD
(See note below, if applicable
C. T IorvaL- (Repair)
Installation Requirements/Conditions Number of trenches
Septic Tank Size ►cSD gallons'"' ' Exact length of each trench feet
Trench Spacing: Feet on Center
Pump Tank Size \300 gallons n - 4 Trenches shall be installed on contour at a
Soil Cover: G inches
Maximum Trench Depth of: 11 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
L inches below pipe
^
Aggregate Depth: Z, inches above pipe
t
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nc Co.,~~PGTG(t~pM
Conditions: 5
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**If applicable: /understand the system type specified is different from the type speciTed on the application. /accept the .rpecifcationr of thin 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 Authnrhation shall not he tnndartnd whnn thorn „ h ~~e „W„e Ai s sk~ T6;.
Construction Authorization is subject to comp th a ovisi of the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent: tZ~as Date: I la, 063
'bristruction Authorization Expiration Date: tS
HTE# Opt-S- ~~`1b43 Permit #
Harnett County Department of Public nealth
Site Slketch
P OPERTY LOCATON: H wy '43"I A
ISSUED T0: ~ioit~ ~JS nee CLcwa~~C f~c~r~ SUBDIVISION LOT #
Authorized State Agent: - 5 \Qf a V EfL 1 dt-K6C~otIF Date: a01 14
301
213,1 ,
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ueparmient ut CIIvuuitmwn, rIt--dltlt, dUU IVdtUldl MtCbVUILVb JI ICt7t.
Division of Environmental Health Property ID:
On-site Wastewater Section Lot
File
SOILiSITE EVALUATION Code:
for ON-SITE WASTEWATER SYSTEM
Owner: Applicant:
Address:
Proposed Facility: 9t aTF.(4~ Design Flow (.1949):
1 ~.ryMQ Q^•~ .
Location of Site: f
Water Supply: Public Individual [ J Well
Evaluation Method: ~;ewage uger Boring [ J Pit
Type of Wastewater: Industrial Process
Date Evaluated:
Property Size:
Property Recorded:
Spring
[ ) Cut
(j Mixed
[ I Other
ak
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
Sob
Depth (IN.)
.1956
Saproa'
Class
; .1944`
Rests
Horiz
Profile ,
Class
& LTAR
i 5
0-1),
C~ 5
VFr, rs1
P5
G s L CP^
~L1'
G 5
vvrti r-ts~'r
S
04 V-
_20'
~ 3
~F~. ~e
PS
l
~,C3-'~
X',~L s c.L
F2 s3
•S
Description
Initial System
Repair System
Available Space (.1945)
\j
V
System Type(s)
v
P< GW
Site LTAR
S
. S
Other Factors (.1946): _
Site Classification (.1948):
Evaluated By: ~j
Others Present: d n