IPACHTE# I 0 -S~ a~ f33 Harnett County Department of Public Health
Improvement Permit
26018
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: a-7'J
ISSUED TO: ~ytsN ~N~sauL-`~p~f SUBDIVISION `T 3C. Potts LOT #
NEWA REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: SkJL~`x~4'>
Proposed Wastewater System Type: °Iaotsp, , S~ m
Projected Daily Flow: 3E,0 GPD
Number of bedrooms: 3 Number of Occupants: j~; max
Basement ❑Yes ANo
Pump Required: ❑Yes ❑ No X May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community Public ❑ Well Distance from well 560 feet Permit valid for. Five years
Permit conditions: ~No expiration
Authorized State Agent::
The issuance of this permit by the Health Department in no way guarantees the e
site is subject to revocation if the site plan, plat, or the intended use changes. The Imp
the Laws and Rules for Sewage Treatment and Disposal and to conditions of this permit.
5 Date: t }I 1 S' V 0 SEE ATTACHED SITE SKETCH
of other permits. The permit h Ider is esponsible for checking with appropriate governing bodies in meeting their requirements. This
'Sent Permit shall not be affected by a change in ownership of the site. This permit is subject to compliance with the provisions of
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: \NJ -JN sv Co cfScn v cC + 0 v PROPERTY LOCATION: aQ
SUBDIVISION =j- N sir, Pa + a c LOT # 9
Facility Type: New ❑ Expansion ❑ Repair
Basement? ❑ Yes No Basement Fixtures? ❑ Yes X No
Type of Wastewater System** 25 JO P\110 0C'1 Sys t.,1 (Initial) Wastewater Flow: 3CC> GPD
(See note below, if applicable
a.S°/ o
Q-E- p Vc:-Nw N S~tsTf-- M (Repair)
Installation Requirements/Conditions
Number of trenches 1
Septic Tank Size j e, coo gallons
Exact length of each trench feet
Pump Tank Size gallons
Trenches shall be installed on contour at a
Maximum Trench Depth of: SB at-1 inches
(Trench bottoms shall be level to +1-114"
in all directions)
Pump Requirements: ft. TDH vs.
GPM
Conditions: \1A~cc~ .e- M
M v.7 'E~ C' o A CA-N' 6
~a.o rti S F_P's t G
4
P
Trench Spacing: Feet on Center
Soil Cover: C la inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
inches below pipe
Depth: inches above pipe
S inches total
gR4LlGhsrt~S tea, z. ~i✓~GrrC;s'T-
**If applicable: / understand the system type spen6ed is different from the type specified on the app/ication. l accept the rpecilcationr o/ chi permit.
Owner/Legal Representative Signature: Date:
This Commirtion Authnrisatinn it uihin sv ,d ;f A. - - r' •r'°~ v,unw,. n¢ wu,uuumu nurnm1LaU011 ]nail 1101 0e uansterrea wnen mere is a change in ownership of the site. This
e Construction Authorization is subj~c~to compliance wi a ons o vs and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent: Date: L-Ir \S ~0
Constr n Authorization Expiration Date: ` ~s ~S`
HTE# t0-S_~U133 Permit # ~60)~
Harnett County Department of Public Health
Site Sketch.
PROPERTY LOCATON:
ISSUED T0: ~rc~ r 2VC-"c~ 0~ SUBDIVISION T~ c~~.r arc LOT
Authorized State Agent: Q X15 OL~v E3Z'Tci~KS~(~ Date: `t~
-13f,
13
i
Department of Environment, Health and Natural Resources Shed:
Division of Environmental Health Property ID:
On-Site Wastewater Section Lot
File
SOILISITE EVALUATION Code:
for ON-SITE WASTEWATER SYSTEM
Owner:
Applicant:
Addrew.
Date Evaluated
Proposed Facility:
Design Flow (.1949):
Property Size:
Location of Site:
Property Recorded:
Water Supply;
❑ Publc ❑ Individual ❑ Well
❑ Spring ❑ Other
Evaluation Method:
❑ Auger Boring ❑ Pit cut
Type of Wastewater:
❑ Sewage ❑ Industrial Process [U Mix
ed
P
R
O
F
SOIL MORPHOLOGY
OTHER
1 .1940
L L &mp
Herizon
.1941
PROFILE FACTOR3
S Poeiflow
# Slope %
Depth
(la)
.1942
.1941 .1941 3011
3h
h
l
.1943 .1936 .1944
Ptoft
ao
w
Congdoon webmw
Taxtan Minnlo Color
Sail Srpro Re*
qMAL1NJ.
Clan Harts
Cfan
ALTAR
-
_
G S vC` .~s~~? .
pdan
7
Repir Sys Other Factors (.1946k
vailablo
S a .19as
Site Classification (.194sk
Sydem a
a 2rao at ~i~a ~n Evaluated By: (V,
Site LIAR
Others Present _
Bfl~~,o ou PQePas~