IPACHTE# Harnett County Department of Public Health 2 5 9 3 5
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION:_ Por+c>~ogq l ress, t
ISSUED TO: o rs gr1...cX_- (7-0 r- SUBDIVISION Gam oL~~oa•, LOT # 3 0
NEW„ < REPAIR ❑ ANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: S IF S0 1 "-C LA
Proposed Wastewater System Type: QLS°Io ~Fa~a;~o ,SyssE~n
Projected Daily Flow: GPD
Number of bedrooms: -A Number of Occupants: g max
Basement ❑Yes No
Pump Required: ❑Yes XNo ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community 'K Public ❑ Well Distance from well i D feet Permit valid for: Five years
Permit conditions: ti ❑ No expiration
Authorized State Agent:: A~ QC-.A--., Date: 3 ~3 10 SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the issuan 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, .1951, .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 LOCATION: Po ~.soosA-~tt _
6t,x SUBDIVISION Cpgc i-N-jN SEAsar.,S LOT # 90
Facility Type: 5T'S:~, Cti') New ❑ Expansion ❑ Repair
Basement? ❑ Yes X No Basement Fixtures? ❑ Yes No
Type of Wastewater System** A5% `SZEs~) UC711- , o N Sys ;Ern (Initial) Wastewater flow: GPD
(See note below, if applicable
D.S°foR 4~sC'sv S-,I5 ar,' (Repair)
Installation Requirements/Conditions Number of trenches a.
Septic Tank Size to o gallons Exact length of each trench a b0 feet
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of. & L, inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
Pump Requirements: ft. TDH vs. GPM
I
Trench Spacing: Feet on Center
Soil Cover: inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
inches below pipe
Depth: inches above pipe
Conditions: WA.~ECz-Ls~ \J'N,3_
inches total
$ta~~ CAN Pcu~poso, ~ciarn Rcee~-~~~rs 5~,. ~ SL.EN~~~<
**If applicable: / understand the ryrtem type .rpeci6ed it different from the type specified on the app/ication. /accept the rpecidcationr of this permit.
Owner/legal Representative Signature: _
This Construction Authorizat on is subject to re
Construction Authorization is subject.4_ocompliance with
Authorized State Agent:
Date:
site plan, pat, or the intended use changes. The Construction Authorization shall not be transferred when there is a change in ownership of the site. This
ro., the s and Rules for Sewage Treatment and Disposal and to the conditions of this permit. SEE ATTACHED SITE SKETCH
_ Date: x316
:io u►hA thorizatlon Expiration Date: <
HTE# 1 0 5-- a j q L{ Permit # 139 -~5
Harnett County Department of Public Health
Site Sketch
PROPERTY LOCATdN: Po NoEsZOgp,~~ att.
ISSUED T0: ~~~o r! 'C 2~CSG CO SUBDIVISION Gp. 2,oL~„ i S sans LOT # -~a
Authorized State Agent oL%4~ ioL,c o~ Date:
~3~t4
lgcI
T
15'
J F Q~ r+ C. Flr4w r-a-5 1)<L-
ss
a- S dlo 2EC) t) ~d N
I 2.Epa,, 2.
r
Department of Environment, Health and Natural Resources Sheet: -
Division of Environmental Health Property ID:
On-Site Wastewater Section Lot
SOIIJSITE EVALUATION File
Code:
for ON-SITE WASTEWATER SYSTEM
Owner: Applicant:
Address: Date Evaluated: 3) _o)
,
Proposed Facility: 1-+ Design Flow (.1949):ti,-t c`
Property Size:
Location of Site: Property Recorded: -
12
Water Supply: Public F1 Individual ❑ Well El Spring [I Other
Evaluation Method: Auger Boring ❑ Pit ❑ Cut
Type of Wastewater:
Sewage ❑ Industrial Piss C1 Nfixed
AR
P
R
O
F
I
1940
SOUL MORPHOLOGY OTHER
.
L Landscape
.1941 PROFILE FACTORS
Horizon
E Position/
# Slope %
.1942
Depth 1941 .1941 Soil .1943 .1936
(la) St
ms
.1944 Profile
ru
Consistence wetnew soil Sapro
Texture Minenb Colo
Reatr Cup
i--5
r IN. Class
Horiz & LTAR
'-_5
o
Descri 'on
Initial Repeir System Other Factors (.1946):
J-
Available S co .1943
Site Classification (.1948): f'5
S stem a
Evaluated By: r.
Site LTAR
< Others Present: