IPACHTE# QAHarnett County Department of Public Health 2 5 8 b 5
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
ISSUED TO: ~rltsctE~}~~scZ~ WtCzrn~S \ -~C_ PROPERTY LOCATION: 06-ciGto Q7
NEW 'X REPAIR [I SUBDIVISION -C''43 LOT # SCt~ Type of Structure: ^E,1(PANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
sC~S7 ~~i0~3~~
Proposed Wastewater System Type: ~.wif.tC\uNP L.
Projected Daily flow: '3>C=,C! _ GPD
Number of bedrooms: - Number of Occupants: max
Basement []Yes No
Pump Required: ❑Yes ❑ No May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community Public ❑ Well Distance from well M )Q) feet
Permit conditions: _ Permit valid for. ~ive years
❑ No expiration
Authorized State Agent:
Date: % O SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the issuance "of other permits. The permit hold is responsible for checking with appropriate governing bodies in meeting their requirements. This
site is subject to revocation it 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 A950, .1952, A954, ,19 1956, .1952, .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: le'j 1Pyq~. ~lpc„ f,r PROPERTY LOCATION: 4b~v i~
SUBDIVISION C.P~tnLl i.1A S>Js LOT # SO
Facility Type: New ❑ Expansion ❑ Repair
Basement? ❑ Yes ❑ No Basement Fixtures? ❑ Yes ❑ No
Type of Wastewater System** ~ ne~IEty~ ~O N ~ L
(See note below, if applicable (Initial) Wastewater Flow: 3ro0 GPD
\...01v-qO iv fit-- (Repair)
Installation Requirements/Conditions Number of trenches Q,
Septic Tank Size t006 gallons Exact length of each trench -15 feet Trench Spacing: Feet on Center
Pump Tank Size gallons Trenches shall be installed on contour at a Soil Cover inches
Maximum Trench Depth of: 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
Conditions: Wacc6Q_ t_ti,vF, Muy-S gE 10 FQan pw OF S Aggregate Depth: a inches above pipe
ia~^ t C_ inches total
Q)i %L_ rTs MP,y ~cvC.QOPGy Q) N !N s-NIPft... OQ, V_UA12. s t*~j .
**If applicable l understand the system type specified it different from the type specified on the app/ication. /accept the specifications of this permit.
Owner/legal Representa ' e Signature:
Date:
This Construction Authorization is subject to tion 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 to complian isions the laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit
SEE ATTACHED SITE SKETCH
Authorized State Agent: Date. 1 a do
Con tion Authorization Expiration Date: kS
NTE# PerT)t-tj)jic #
Harnett (bounty I)et~altment of Health
Site sketch
PROPERTY LOCATON: Po,►QESLO,54
ISSUED T0: ~ EC1 tnp cL~1 ~ N L SUBDIVISION GPr~.cL) ~tA
S~''SOi'S LOT # 10~
Authorized State Agent: ~o~w(rtt_'C6Lxsoor
Date:
1
11
-
Depmune d of Environumd, Health and Natural Resources
Division of Environmental Health
on-site Wastewater section
SOIIJSTTZ EVALUATION
for ON-STTIC WASTEWATER SYSTEM
Applicant
Address: Date Evalimto k ~
PrOpo6od Facility: 3 e-nano Design Flow (.1949). 4 o, e
Locktiaa of sits
Prop" Recorded.
Water Supply: Individual ❑ Well
Evalueden Method: Anger Horin6 ❑ Pit L
Type of Wastewater: Sewage ❑ Industrial Pros a
shat:
Property m):
Lot g:
File N:
Coco:
Property Size:
❑ SPW ❑ Other
cut
Mired
k
P
R
O
F
I
1940
OM MORPHOLDOY
.1941
THER
PROFILE FACTORS
L
B
M
I.mhm"
slPOW" ope %
Haim
~
.1941
I
TUMM
.1941
conwd
mbwalm
.1941
son
Weald
Cater
.1943
Sod
.1936
Sepr+o
Ciw
Raw
.1944
Ree1r
Hods
te»
~
R LIAR
2-
c7-fir
4971
5
site cblsiBcadan (.1949, t
Ealuawl By
a
Others presmt: