IPAC RRHTE s Ir ~ (aQ Harnett County Department of Public Health 2 5 9 0 4
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
ISSUED T0:Zo PROPERTY LOCATION: `3+-~Gs NvczcZ%s 9
"Gv e uX~F~2~~ , ~f SUBDIVISION
NEWX of Structure: 5REPAIR ❑ LOT # r1,5
Type XPANSION 11 Site Improvements required prior to Construction Authorization Issuance:
(~1H~x~ '
Proposed Wastewater System Type: Nr(\0 -sa ol5% Ucrtor~ j -):5 1EY)
Projected Daily Flow: 3F GPD
Number of bedrooms, 3 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 i00
Permit conditions feet Permit valid for. ~ Five years
❑ No expiration
Authorized State Agent:: QC~S
Date: 3 1 SEE ATTACHED SITE SKETCH
The issuance n( this permit by the Health Department in no way guarantees the is of other permits. e site. This permit is subject to compliance with the
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 Impro nt Permit shall not be affected by a change in ownership of th 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, .1957, .1958. and .1959 are incorporated by references into this permit and shall be met. Svcramc <hA tie
with the attached system layout
ISSUED T0: ~m dry rr2s C- PROPERTY LOCATION:
--r~~ct2 s R~
Facility Type: -yk,
SUBDIVISION ~S l
New ❑ E
l I i,,,,,, Qom, LOT # a-j
xpansion ❑
Basement? ❑ Yes No Basement Fixtures? ❑ Yes X No
Repair
Type of Wastewater System** Qv a'ln
aSd(o R o(-) c,~ s~~N
(See note below, if applicable
(Initial) Wastewater flow: 3~~3 Gpp
Pcs c~.ta c
g`o ~.ES~ uG Aso
Installation Requirements/Conditions
(Repair)
Number of trenches I
Septic Tank Size 100 gallons
Pump Tank Size
allons
Exact length of each trench 190
T
feet Trench Spacing: Feet on Center
g
renches shall be installed on contour at a
Soil Cover: C -lam inches
Maximum Trench Depth of., ►B -20-4
inches (Maximum soil cover shall not exceed
(Trench bottoms shall be level to +/-1/4"
36" above the trench bottom)
Pump Requirements: ft. TDH vs.
in all directions)
GPM
Conditions: o~~t n C uSrt ~G
~Q~ c
Ep S\~ ~~SCT M
inches below pipe
Aggregate Depth: inches above pipe
{\b
~
CX.10 C-- 0. 1*, t-c NIA
99>v~¢..
V
l> \~1F~
inches total
*If applicable /understand the system type specified is different from the type specired on the app/ication. /accept the rpec1f1catianr of thi permit.
Owner/Legal Representative Signature:
This Construction Authorization is subject to revocation if the site plan, plat, or the intended use changes. The Construction Authorization shall not be transferred when tDate:
here is a change in ownership of the site. This
construction Authorization is subject compliance ions he taws and Rules for Sewage Treatment and Disposal and to the conditions of this permit.
P~ SEE ATTACHED SITE SKETCH
Authorized State Agent:
Date: 3 ~ 1
~trudionhorization Expiration Date: 3
HTE# Permit # 3-5`)y
Harnett County Department of hiblic Health
Site Sketch
ISSUED T0: PROPERTY LOCATON:c oc~a ~s Q n
cn drGtE -2~ w G SUBDIVISION 7N
V v LOT #S
Authorized State Agent: - aa5 C~ w C5z °TOuy Date: 1C)
%0"
Department of Environment, Health and Natural Resources Sheet:
Division of Environmental Health ,
On-Site Wastewater Section Property ID:
Lot `
SOUAITE EVALUATION File
for ON -SITE U7A,S Cow
EWATER SYSTEM
Owner. Applicant:
Addmss: Date Evaluated:
1949):
Proposed
c"ty:'3 2r x Design Flow (
.
Location of
Site:
~ Recorded:
ply
Size:
Water Supply
: Pubtic
❑ Indivia ❑ Well
Evaluation Method
❑ Spring
❑ Other
: Auger Boring
❑ cut
Type of Wastewater: Sewage ❑ Ind
i
t
l
us
r
a
Process ❑ Infix
ed
P
R
-
O
F
1940
I
SOIL MORPHOLOGY
OTHER
.
L L~Cepe Horizm
.
1941
PROFILE FACTORS
E P-Mod Depth
Slope % (la)
.1941
sbuch"
.1941 .1942
soil
conwAawe
1943
.1936 .1944
Profile
Taxk"
wetnew
MhWelo
sod
C Re*
Clap
l ~S~ r O LS
~i F ti tvs~ ,a
lose Honz
& LTAR
ps .
C
T
uuier r'actas (.1946):
Site Classification (.1948
s aE~ a ~o z.6 Evaluated By:
Others Present: