IPAC RRHTE#C)01 -5~a-5NJ"- Harnett County Department of Public Health
2f 01 5
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
ISSUED
PROPERTY LOCATION: Cam),'-r- ct~/ P~~•C ~1~J
T0: _
p,aC,~t-
SUBDIVISION C
g
P
NEW
REPAIR ❑
_e„C
t y y
a~¢~
LOT #
,
Type of Structure:
EXP SION ❑ Site Improvements required prior to Construction Autho
'~~47LS~ ns5
rization Issuance:
P
F'
°
roposed Wastewater System "T pe:
16 nQ_,S an
v n.e AA aS
P
rojected Daily Flow:
GPD
N
b
f
3
um
er o
bedrooms:
'
Number of Occupants: max
Basement ❑Yes
KNo
Pump Required:XYes
❑ No
❑ May be required based on final location and elevations of facilities
Type of Water Supply:
P
i
i
❑ Community
1 Public ❑ Well Distance from well tb O feet Permit valid for.
Five years
erm
t cond
tions:
~
❑ No expiration
Authorized State Agent:: Q.E~_5Date: 1 to SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the issua ce of other permits. The permit hold 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 taws 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 J950, .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: ts.NC ~L Dui LoF a 5 ~N L PROPERTY LOCATION: CZ u PAc~c Lrs
SUBDIVISION Cova s- fry f~rzc_ LOT #
Facility Type: l;;7-A) C50 ASS New ❑ Expansion ❑ Repair
Basement? ❑ Yes No Basement Fixtures? ❑ Yes 'X No
Type of Wastewater System' 9u ~P \ G 25°Jo ~tog(:7 io J y'-Yse4f, (Initial) Wastewater Flow: -~CO GPD
(See note below, if applicable
~?j, `T,) 26.4 oc.c~sSonl Sys-~E c~ (Repair)
Installation Requirements/Conditions Number of trenches
Septic Tank Size o 0o gallons
Pump Tank Size Joao gallons
Pump Requirements: ft. TDH vs.
Conditions: dr,
Exact length of each trench Z3Zj feet
Trenches shall be installed on contour at a
Maximum Trench Depth of. _ inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
GPM
S
OU 1,- v1 ic-'L. oa
-4 1"1~) J Nw L'sli~i "f o cJ . ~CL ~i~tGl 1 bCLN' 9-Lq V ,
Trench Spacing: Feet on Center
Soil Cover: inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
Aggregate Depth:
t✓•~• . ~O 0\ L K~ES
inches below pipe
inches above pipe
inches total
AL Sucor.~ r~FD
**If applicable: /understand the system type specired is different from the type rpec111ed on the app1mition. / accept the rpeci6cationr of this permit
Owner/Legal Representative Signature: Date:
This Construction Authorization is subje o revocation if the site plan, plat or the intended use changes. The Construction Authorzaton shall not be transferred when there is a change in ownership of the site. This
Construction Authorization is subject to complianc ovisi 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: 1 t to
Construction Authorization Expiration Date: IA W IS'
HTE# d`t - S-~33~1 ~l2 Permit # 2~b 15
Harnett County I)epartment of nealth
Site Sketch
PROPERTY LOCATON: Co~3Ue-~ ~~ze-1
ISSUED T0: L~u SUBDIVISION Cver ucci LOT # C°1
Authorized State Agent: (v,S LtivC idLYSSXy QF) Date: t't11110
&C
o
Go Nr` ~C~ r~
o
Department of Environment Health and Natural Resources
Division of Enviromnental Health
On-Site Wastewater Section
SOUBITE EVALUATION
for ON-SITZ WASTRWATeR SYSTEM
Owner. Applicant:
Addrew:
Proposed Facility:
IA *d= Of Site:
Water Sllpp>1T.
Evaluation Method:
Type of Wastewater:
Date Evaluated:
Design Flow (.1949):
❑ PubliC 0 ❑ Well
❑ Auger Boring ❑ Pit p
❑ Sewage ❑ Industrial Process C7
Shed:
Property H):
Lot
File
Code:
Property Size:
❑ SPW ❑ Other
cut
Mixed
P
It
O
F
1
1940
OIL MORPHOLOOY
.1941
THER
PROFILE FACTORS
L
*
Ladumpe
Sk" %
Hari,"
(IL)
.1941
Strmh"
Temme
.1941
Comm am"
MiweiO
.1941
Soil
Webmw
Coto
.1943
Soil
.1936
SWO
Clem
.1944
Re*
Harts
Proms
C1w
& LTAR
i
G 3~
~ 5
v'~n N~l~~
5
din N>)~f'
C
C7
1
x
r
Other Factors (.1946k
Site Classification (.1948r C'~
a , Evaluated B): OS
Others Presentt.