IPACHTE# Harnett County Department of Public Health 2 6 01 4
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: 114Ww l c)Q
NEW ISSUED TO: Cz-`1D E ~~R^a SUBDIVISION L-$ LOT #
REPAIR ❑ EXPAVON . -El Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: Ma.~ N_~Oto, -
Proposed Wastewater System Type: [cy,.,vF sSsorrn.~
Projected Daily Flow: GPD
Number of bedrooms: Number of Occupants: max
Basement ❑Yes No
Pump Required: ❑Yes ANo ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community N Public ❑ Well Distance from well _lOa feet Permit valid for. ~ive years
Permit conditions:
❑ No expiration
Authorized State Agent.: Date: TO SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the issuance-perm-its. 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: C-r-ODE. V-is oaf PROPERTY LOCATION: NWy
Type: SUBDIVISION L IF-l1 LOT #
Facility _
New ❑ Expansion ❑ Repair
Basement? ❑ Yes >q No Basement Fixtures? U Yes _~<No
Type of Wastewater System*'t C.,Z) rtV o ~J A~ (Initial) Wastewater Flow: 3~ d GPD
(See note below, if applicable
C-40 \re 1N o>`TQ`L- (Repair)
Installation Requirements/conditions Number of trenches 3
Septic Tank Size 6 (!~)c9o gallons Exact length of each trench En feet Trench Spacing: Feet on Center
Pump Tank Size gallons Trenches shall be installed on contour at a Soil Cover. l a.~ inches
Maximum Trench Depth of: a~"3~7 inches (Maximum soil cover shall not exceed
(Trench bottoms shall be level to +1-114" 36" above the trench bottom)
in all directions)
Pump Requirements: ft. TDH vs. GPM
inches below pipe
J , Ag egate Depth: - inches above pipe
Conditions: vC_ SS b
inches total
*If applicable: l understand the srs tem type recifed it different from the type specified on the application. / accept the .rpecfcationr of this permit.
Owner/legal Representative Signature: Date:
This Construction Authorization is sub ect 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 subj~ comp w ns of the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent: Q1_
Date: No
con t uthorization Expiration Date: \a IS-
HTE# t O' S a'~ Permit # D,4Q -i
Harnett County Department of Public Health
Site Sketch
ISSUED TO:
Authorized State Agent.
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LOT #
Date: L1~ 1 l 0
PROPERTY LOCATON:
- SUBDIVISION ~-E2>
1)3'
Department of Environment, Health and Natural Resources Sheet:
Division of Environmental Health
On-Site Wastewater Section Property 1D:
Lot
SOIUSM EVALUATION File M:
for ON-SYTV Code:
WASTEWATER SYSTEM
owner. Applicant:
Address; Date Evaluated: Li) a), , 0
PmpOSed Facility: 3 0C0a6cx,,,5 Design Flow (.1949): 6V Property size:
Location o[ Site: Property Recorded:
water Suppler Public [I Individual Well ❑ Spring ❑ Other
Evaluation tldethod: ,43 Auger Boring ❑ Pit ❑ cut
Type of Wastewater: IR Sewage ❑ Industrial Process Mixed
R
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SOIL MORPHOLOGY
.1940
1941
1 an bo"
Horizon
Position/
Depth
.1941 .1941
Slope %
(Ice)
sfrucWty Comistmq
T• Miasralo
~.5
0,
'
s IG3
aP
OTHER
PROFILE PAC
.1941
soil 1943
Weft Q.Js
.1956
repro
.1944 Pfome
Redr CIM
Hain d LTA
S V
s eta 1O 3Y'tam Other Factors (.1946k
Site ChmMation (.1948r 5
CO M
d Evaluated B)r M
70i Othas Prexnt