IPACHTE#/0 -s Z-Y/dz Harnett County Department of Public Health 2 5 7 4 a
Improvement Permit
A building permit cannot be issued with on! an Improvement Permit
PROPERTY LOCATIO
ISSUED TO•5,7i WCZY/ SUBDIVISION LOT # c7
NEW Rr REPAIR ❑ EXPANSION ❑ Site Improvements re q&40 prior to Construction Authorization Issuance:
Type of Structure: T D
Proposed Wastewater System Type:
Projected Daily Flow: -_S Co.O GPD
Number of bedrooms: -~'3- Number of Occupants: max
Basement ❑Yes I No
Pump Required: ❑Yes ❑ No [ Ma a required based on final location and elevations of facilities
Type of Water Supply: ❑ Community 1?1 Public ❑ Well Distance from well feet Permit valid for. L2' Five years
Permit conditions: ❑ No expiration
Authorized State Agen . Date: y -/5 -[b
SEE ATTACHED SITE SKETCH
The issuance of this permit by alth Department in no way guarantees the issuance of other permits. The permit holder is responsible for checking with appropriate governing bodies in meeting their requirements. This
site is subject to revocat on if 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 TO:5~OW PROPERTY LOCATION:
/ SUBDIVISION LOT #
Facility Type: ~ D _ Q New Expansion ❑ Repair
Basement? ❑ Yes No Basement Fixtures? ❑ Yes N
Type of Wastewater System" (Initial) Wastewater Flow: 3 G U GPD
(See note below, if applicable
-r (Repair)
Installation Requirements/Conditions Number of tr riches Septic Tank Size A!>0 C> gallons Exact length of each trenchT_ feet
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of. 2-4 inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
Pump Requirements: ft. TDH vs. GPM
Conditions:
Trench Spacing: / Feet on Center
Soil Cover. _ 6 inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
_ 4- inches below pipe
Aggregate Depth: 'Z_ inches above pipe
/ Z inches total
*If applicable: /understand the system type specified is different from the type specified on the application. / accept the specifications of this permit.
Owner/legal Representative Signature: Date:
This Construction Authorization is subject 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 subject to compliance with the provisions of the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit. SEE ATTACHED SITE SKETCH
Authorized State A t: Date: y - !a
Construction Authorization Expiration Date: Y -t! - t 5
HTE# /0 -5- - Zy10,Z Permit # 225 7 91/0
Harnett County Deptilinent of -Miblic Health
Site 'S'keteb
_ PROPERTY LOCATON: d Co~~ .GO
ISSUED T0: S/~~ ,~y 1!'1 C- SUBDIVISION C'a LOT #
Authorized State Age G Date:
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Department of Environment, Health and Natural Resources Sheet:
Division of Environmental Health Property ID:
On-Site Wastewater Section Lot
File
SOILISITE EVALUATION Code:
for ON-SITE WASTEWATER SYSTEM
Owner: Applicant:
Address:
PmpoW Facility: 5 ~
Location of Site:
Water Supp1r.
EvaluadonMeihod:
Type of Wastewater: &
Date Evaluated:
Design Flow (.1949): Property Size:
Property Recorded:
ilc ❑ Individual ❑ Well ❑ Spring ❑ Other
Auger Boring ❑ Pit 8 Cot
E'bw6p ❑ Industrial Process Mixed
P
R
O
P
1
L
E
A
1940
1.udempe
PositioW
Slope %
odum
Depth
00
OIL MORPHOLOGY
.1941
.1941 .1941
Sttne"W Coneldtem
Textwe mbmab
THER
PROFII.B FACTORS
.1941
SOU .1043 .1956
webmw soil S"m
Color IN. Clue
1944 Pm ft
Restr Cis
Haft # LTA>!
i
L_ 5,4
6 - ZD
5L
-
Z
L
~ -r t>
sit-
^
3
~
o ~to
err;
r
1o to
!
[7bl*pdon
s
,
sit. LT AR
_
9a5
Wtid Repok System Other Factors (.1946k
s sits
classi$cation (.1948r /
Evaluated By:
rv Other's Present: