IPAC RHTE# /'i A Harnett County Department of Public Health 2 5 8 4 8
Improvement Permit
A building permit cannot be issued with only an Improvement ~ermit
PROPERTY LOCATIO : >
ISSUED TO•~(~~~~~~~ lt~~"~~J SUBDIVISIONS LOT # iZ
NEW ?I' REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: JF P J-~7- Y5- z
Proposed Wastewater System Type: CC-i U -A 't
Projected Daily Flow: ~J b0 GPD
Number of bedrooms: 3 Number of Occupants: max
Basement ❑Yes 210
Pump Required: ❑Yes VNo ❑ be required based on final location and elevations of facilities
Type of Water Supply: [I Community MaPublic ❑ Well Distance from well feet Permit valid for I"f Five years
Permit conditions: ❑ No expiration
Authorized State Agent:: e==. Date: c2~~ SEE ATTACHED SITE SKETCH
The issuance of this permit by a Health Department in 'To-way guarantees the issuance 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, .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:
PROPERTY LOCATI N:
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SUBDIVISION 1~tA
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ype:
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New ❑ Expansion ❑ Repair
Basement? ❑ Yes No Basement Fixtures? Yes ❑ No
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ype o
astewater System
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(Initial) Wastewater Flow: GPD
(See note below, if applicable
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cc~ +r~-~F- 'C~ic-Q-~ (Repair)
Installation Requirements/Conditions
Number of trenches
Septic Tank Size <X gallons
Exact length of each trench 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. 30 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 1 cr 4l4It 4 or
/.Z inches total
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**If applicable: / anderrtand the system type specited is different lrom the type speciped on the app/ication. / accept the specifications of this 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 Authorization shall not be transferred when there is a change in ownership of the site. This
Construction Authorization is subject to compli a 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 Agent Date: 61 4'Ile
Construction Authorization Expiration Date:. 161
I"lar' tJz) I U UZI; ezja m i cnae l eaKer U l Ubee454U P.1
Southeastern Soil & Environmental Associates Inc.
P.O. BOX 9321
Fayetteville, NC 28311
Phone/Pax(910) 822-4540
Email mike@southeastemsoil.oom
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SOIL/SITE EVALUATION • SOIL PHYSICAL ANALYSIS • LAND USE/SUBDIVISION PLANNING
GROUNDWATER DRAINAGE/MOUNDING • SURFACE/SUBSURFACE WASTE TREATMENT SYSTEMS, EVALUATION & DESIGN
rear va l u m i cnae 1 eaKer y 1 uuee4b4u
SOUTHEASTE'N SOLL & ENVIRONMENTAL ASSOC, INC.
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P.ROPOSIi U SUBSURVACE WASTE DISPOSAL SYS'I'It:NI DETAIL S1-1LL 1'
SUBDIVISION k4-io^ 1.e'~i
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INITIAL S'Y STF. M C~tv Krca.,q
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DISTRIBUTION O-A,-)c
LOCATION I--+ c , ~2
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BY A k `4V V - DATE e
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Dgmbic* of E>tvismMaek Health and Nahual Retoumes Sleet:
Division of EavimnmeaM Health Property ID:
On-Site Wastewater Sects Lot
SOIIJSITZ &VALUATION File ik
for ON-S1TZ WASTEWATER SYSTn j code:
owner Applicant:
Addram- Dale Evaluated: ` 1 c 9~c~ c
I acmdamj Design Flo R~~ ~pah Siu:
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waw a -Ste' ❑ wiv>dmd❑ C] weu 13 SPA ❑ Other pit cut
'type °f Wagaw'lar: 9 se~rada ❑ wusiat Procsaa 8 Mixed
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