IPACHTE# /0- = 3 7 77 Harnett County Department of Public Health 2 5 8 3 9
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATIO : d
DD
NEW /411-C-f SUBDIVISION v LOT #
REPAIR ❑ EXPANSION ❑ Sjte Improvements required prior to Construction Authorization Issuance:
Type of Structure:
Proposed Wastewater System Type: _-r V 16A_
Projected Daily flow: _ 6 GPD
Number of bedrooms: ~ 3 - Number of Occupants: L max
Basement ❑Yes 2 No
Pump Required: ❑Yes [?'No ❑ MMa~e required based on final location and elevations of facilities
Type of Water Supply: ❑ Community L Public ❑ Well Distance from well feet
Permit valid for. P4ve years
Permit conditions:
❑ No expiration
Authorized State Agent:: / Date: Z of d SEE ATTACHED SITE SKETCH
The issuance of this permit by th ealth Depart ment in no way guarantees the issuance of other permits. The permit holder is responsible for checking withappro priate governing bodies in meeting their requirements. This
s to is subject to revocation if the site plan, plat or the intended use changes. The Improvement Permit shall not be aHeaed by a change m ownership of the site. This permit is subject to com with the provisions of
the taws and Rules for Sewage Treatment and Disposal and to conditions of this permit pliance
.
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. Systems shall be installed in accordance
with the attached system layout.
ISSUED T0: q~~cy %CQ•~eJ ~,r~ PROPERTY LOCATION: ~y c'4
SUBDIVISION 44 LOT #
Facility Type: _5~jFc) P'New ❑ Expansion ❑ Repair
Basement? ❑ Yes No Basemen Fixtures?. ❑ Yes ❑ No
Type of Wastewater System** (Initial) Wastewater Flow: GPD
(See note below, if applicable
v~~<du- ki-~e.~. (Repair)
Installation Requirements/Conditions Number of trenches ,3
Septic Tank Size -/00 Q
gallons Exact length of each trench C feet
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of. 1? -2, inches
(Trench bottoms shall be level to +1.114"
Pump Requirements: ft. TDH vs.
Conditions: 12a
C'AD /0
in all directions)
Trench Spacing: _YFeet on Center
Soil Cover. G -12 inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
GPM inches below pipe
Aggregate Depth: inches above pipe
0. ft C G A Adcar v j J~~ inches total
41-1 C l /'/Ie cam.
`*If applicable: / understand the system type speclled is different from the type specified on the application. / accept the speciTcations of this permit.
Owner/Legal Representative Signature: Date:
This Consaucnon Authorization is subject to revocation if the site plan, plat, or the intended use changes. The Construaion Authorization shall not be transferred when there is a change in ownership of the site. This
fonstruction Authorization is subject to compliance with the provisions of the laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State
Date:
Construction Authorization Expiration Dater
2-c/
IJJ`
HTE# 02,,.3772 Permit # a37F,3~
Harnett ComitY Depailment of 1--,Il blic -Health
Site sketch
ketch
PROPERTY LOCATON: llyr,r f
ISSUED TO: / l(~ ! SUBDIVISION S e LOT #
c
Authorized State Agent: E c~ _C' if f
Date:
~cC- , c> 3c" J 6 t,
Department of Environment, Health and Natural Resources
Division of Environmental Health
On-Site Wastewater Section
SOIIJSTTE EVALUATION
for ON-SITE WASTEWATER SYSTEM
Owner: Ap
Address:
Proposed Facility:
Location of Site:
Water Supply:
Evaluation Method:
Type of Wastewater:
plicant:
Date Evaluated: -Z, ~
Design Flow (.1949):
Property Recorded:
[Public ❑ Individual ❑ Well
uger Boring ❑ Pit ❑
Sewage ❑ Industrial Process ❑
Sheet:
Property ID:
Lot
File
Code:
Property Size:
❑ Spring ❑ Other
cut
Mixed
P
R
O
F
1
L
1940
L
d
SOU. MORPHOLOGY
.1941
OTHER
PROFILE FACTORS
E
#
an
aoape
Poeitiod
Slope %
Hanzon
Depth
(lo.)
.1941
sbwtww
Texhire
.1941
Coaddawe
Mimalo
1941
soil
webmw
Color
.1943
Soil
Dep& IN.
.1956
sepro
Clan
.1944
Rm&
Hodz
Profile
Clan
& LTAR
r--
L
ar ayu= Uther Factors (.1946).
Site Classification (.1948):f
Evaluated By:
Z Others Present: