IPACHTE# fo- s-~,~a Harnett County Department of Public Health 2 5 9 4 0
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: tyo2~+a Y s f-W d 2.Y
ISSUED TO: aaE L --UC.o,y ~or,~-~ SUBDIVISION Sy~sE.-t R~~GE LOT #
NEW REPAIR 0 PANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: S q O
Proposed Wastewater System Type: C-a wv L,,r,7 P~
Projected Daily Flow: ~j F,O GPD
Number of bedrooms: 3 Number of Occupants: max
Basement ❑Yes No
Pump Required: ❑Yes 'X No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community X Public ❑ Well Distance from well t0 O feet Permit valid for. Five years
Permit conditions: ❑ No expiration
Authorized State Agent:: -`1~5 Date: al,q 10 SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the issuance of o ermits. 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 TO: czxaC L L.,j c,r>s IN G PROPERTY LOCATION: ~oc,-~1v~E~rv ~)a.y Ir,
SUBDIVISION Su,a 5t:c r. E LOT # S
Facility Type: SVC)LZ-) New ❑ Expansion ❑ Repair
Basement? ❑ Yes ~X No Basement fixtures? ❑ Yes , No
Type of Wastewater System** C10 -'JeP4-~ V Q N ,DAL,
(See note below, if applicable
C.o ".rE...r-, ~o r4 r,~-- (Repair)
Installation Requirements/Conditions Number of trenches `QL
Septic Tank Size 1 C2 od gallons Exact length of each trench -15 feet
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of: C, inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
Pump Requirements: ft. TDH vs. GPM
(Initial) Wastewater Flow: '340 GPD
Trench Spacing: C1 Feet on Center
Soil Cover: la-2,t i inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
C inches below pipe
Aggregate Depth: inches above pipe
Conditions: W ► 7ex-, 1_v N~ M Est In F"~rM S F,pt , C- S')s- Sa inches total
U L • ES or/ N c.cLC~ p. L~ N \ N ~a.1. a2 F P a,Nti- Nat- P
* If applicable: / underrtand the ryrtem type rpecihed it diNereat from the type speciTed an the app/ication /accept the rpecificationr of thi permit.
Owner/legal Representative Signature: Date:
This Construction Autheim2tinn is tAi,rts ro ,,t r t .;..cwt
nUUmnLauun span not De transterreo when there is a change in ownership of the site. This
Construction Authorization is subject to compliancIt t is o ws and Rules (or Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent: R~' Date: 3 a°I to
Constru n Authorization Expiration Date: a~
HTE# ICS Permit #
Harnett County I)epai-t nent of I-~iblic Health
Site Sketch
PROPERTY LO(ATON: NoafN-Wg
ISSUED T0: rAGL vcp,5 ~j~s~ , ~N~, SUBDIVISION S ur+SC LOT # -7_
Authorized State Agent:
~~s L9L~~ Flt ` toL 3' 10
Date:
T
L Od
ao5
Department of Environment, Health and Natural Resources
Division of Environmental Health Shat:
On-Site Wastewater Section Property ID:
Lot
SOHAITE EVALUATION File
for ON-SITE WASTEWATER SYSTEM Code:
Owner. Applicant:
A
Proposed ddress: Date Evaluated: 3 /-I q
Location of Facility: 3 ~r~Qo -1, Desip girded: '36 cs~e Property Size: Prop" Water Supply: Public ❑ Individual
Evaluation Method: Auger Boring ❑ Pit ❑ Well ❑ ❑ SP~B ❑ Other
'type of Wastewater: ❑ Industrial Process ❑ M cut
fixed
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Site Clarification (.1948r 5
c r~ TT Evaluated By: 0,m~
Others Present:
OTHER
.1941 PROFILE FACTORS
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