IPACHTE# /0Harnett County Department of Public Health 2 5 9 5 3
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION:
ISSUED TO: s7+Cvc. Tt\Q&"--f SUBDIVISION : Zvi omcF-t o fir' LOT #
NEW REPAIR ❑ E~ PANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: ~FA-)_ 39 4ti
Proposed Wastewater System Type:
~y~-~
Projected Daily Flow: 80 GPD
Number of bedrooms: Number of Occupants: max
Basement ❑Yes Jlo
Pump Required: ❑Yes ❑ No ER Ma be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community Public ❑ Well Distance from well feet Permit valid for.
Permit conditions:
Five years
❑ No expiration
Authorized State Agent:: 27., ~f Dater 3 1,5 Qa SEE ATTACHED SITE SKETCH
The issuance of this permit by a Health Department in no 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, ASS, .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
J ~
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:
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htr
PROPERTY LOCATION:
c~
Facility Type:
SUBDIVISION /t c~, cz
New ❑ Expansion ❑ Repair
LOT #
Basement? ❑ Yes ❑ No Basemen
t Fixtures? ❑ Yes ❑ No
Type of Wastewater System** d r' y,
tQrdvc `.c.1 ~S/l ter-
(Initial) Wastewater flow: 4190 GPD
(See note below, if applicable
~c:
`CJ V c ~ j~ (Repair)
Installation Requirements/Conditions
Number of trenches 13
Septic Tank Size IM 0 gallons
Exact length of each trench :70 feet
Trench Spacing: Feet on Center
Pump Tank Size gallons
Trenches shall be installed on contour at a
Soil Cover. (o inches
Maximum Trench Depth of: - /8 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: 5--~ew. art 6 ~~ecyl,
inches total
j
cn~ e- ~C1 `~'F, ~ey ~-V .~O.I" d SSG . c .Si✓j N1_
*If applicable: l understand the system type specified is different from the type specified on the application. l accept the specifications of this permit.
Owner/Legal Representative Signature: Date:
„1„-1.,x„ , -J- c.utatwu n me site pion, plat, or me mtenaea use cnanges. ine construction nuthonzation shall not be transferred when there is a change in ownership of the site. This
Construction Authorization is subject to compliance with the provisions of the laws and Rules for Sewage Treatment and Disposal and to the conditions of this Dermit. SEE ATTACHED SITE SKFTCH
Authorized State Agent: Date:
Construction Authorization Expiration Date:. 2cf~~`
HTE# ./c',5- 2,3 ~c-7 Permit # R S3
Harnett County Department of lNiblic Health
Site Sketch
f PROPERTY LOCATON:
ISSUED TO: rkAl xr SUBDIVISION LOT # _
Authorized State Agen y~ Date: 0X /G
f
~y~
Department of Environment, Health and Natural Resources
Division of Environmental Health
On-Site Wastewater Section
SOIL/SITE EVALUATION
for ON-SITE WASTEWATER SYSTEM
Owner: Applicant: /
Address: Date Evaluated:' z (z
Proposed Facility: Design Flow (.1949):
Location of Site: Property Recorded:
Water Supply: ql~ lic ❑ Individual [I Well
Evaluation Method. ger Boring ❑ Pit ❑
Type of Wastewater: i Sewage ❑ Industrial Process C]
Sheet:
Property ID:
Lot
File
Code:
Property Size:
❑ Spring ❑ Other
cut
Mixed
P
R
O
F
I
1940
OUL MORPHOLOGY
.1941
THER
PROFILE FACTORS
L
E
#
Landscape
Position/
Slope %
Horizon
Depth
(In.)
.1941
Structure/
Texture
.1941
Consistence
Mineraio
.1942
Soil
Wetness/
Color
.1943
Soil
Depth IN.
.1936
Sepro
Class
.1944
Restr
Horiz
Profile
Clan
& LTAR
Gt"
Description
Initial
System
Repair System
Other Factors (.1946):
Site Classification (
1948):"" 5"
Available Space .1943
!
.
Evalu
t
d B
System Tn*s)
2 -
l
a
e
y:
Oth
P
Site LTAR
ers
resent: