IPACHTE#~ ~s 9,`1111/ Harnett County Department of Public Health 2 3 9 7 3
ISSUED TO: ~/ri o~~-f~~ :c.~. alemv(vnu f ~ ~ ~ r~.~ IAr u ~ ~
NEW e- REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance.
Type of Structure: q 1
Proposed Wastewater System Type: C- Ue~
Projected Daily Flow: < GPD
Number of bedrooms: Number of Occupants: max
Basement ❑Yes L9'fo
Pump Required: ❑Yes ❑ No MMaa be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community L~ Public ❑ Well Distance from well feet Permit valid for: F Five years
Permit conditions: ❑ No expiration
Authorized State Agent:: `L ~ ~ Date: SEE ATTACHED SITE SKETCH
The issuance of this permit b e Health Department m no way guarantees the issuance of other permits. The permit holder is responsible (or 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: ~l.2n c~ 1dl '~t ~~X .rare PROPERTY LOCH ON: cs~ ~I"
SUBDIVISION ocs s yet ,ter LOT #
Facility Type: ~F ` _ Imo' New ❑ Expansion ❑ Repair
Basement? ❑ Yes No Basement Fixtures? ❑ Yes ❑ No
Type of Wastewater System" CCU ve A = C ~t ~ (Initial) Wastewater Flow: C GPD
(See note below, if applicable ~r
~Y~ ~Ce~c~~c~t1~~+._ (Repair)
Installation Requirements/Conditions Number of trenches
Septic Tank Size 00 0 gallons Exact length of each trench /,5~0 feet Trench Spacing: Feet on Center
Pump Tank Size gallons Trenches shall be installed on contour at a t'`'om Soil Cover: ! inches
Maximum Trench Depth of- R q inches (Maximum soil cover shall not exceed
(Trench bottoms shall be level to +/-1/4" 36" above the trench bottom)
in all directions)
Pump Requirements: ft. TDH vs. GPM inches below pipe
Aggregate Depth: inches above pipe
C ndi jons: o r 1 1 ! o vo~ ; / j Z inches total
4Sa.~- r :.1 c / Li b t cb / zC~ f = ~J r - l c ~S t lti lf~M .
A applicable: / understand the system type Specified is different from the type specified on the application. l 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
~muuuCumi nmomiiauon a wmteu ru cumpnance wun me provisions or me taws and Rules for Sewage treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKEILH
Authorized State Age ~f Date: J ~ 1~
Construction Authorization Expiration Date: ' i3 ~2 (T 1_f-
Improvement Permit
A building permit cannot be issued with only an (Improve ent Permit
PROPERTY LOCATION: /'1 o.r-~ ;~c~.
HTE#
Permit # 5`-T? -3
Harnett (county Department of Miblic Health
Site Sketch
PROPERTY LOCATON: A,-,'I"
ISSUED TO: A SUBDIVISION a s LOT #,J7
Authorized State Agent Date:
P
c A r~ ~
/'<4t jC:a^
f ~
DePdment of EwAmnnmt, Health and Natural Resource Shed:
Division of Environmental Health Property ID:
On-Site Wastewater Section Lot
Cam:
SOIL/S1TE EVALUATION File
for ON,4ITE WASTEWATER SYSTEM
Owner. Applicant: ~at
Address: Date Evaluated: `l
Proposed Facility, Design Flow (.1949): Property Size:
Locations of Site. Property Recorded
Water Supplfy ['Public ❑ Individual ❑ Well ❑ Spring
Evaluation Method: [r] Auger Boring ❑ Pit Chit
Type of Wastewater: Sewage ❑ Industrial Process H Mixed
P
R
O
F SOIL MORPHOLOGY OTHER
1 .1940 .1941 PROFtIB FACIY
L Lzubnpe Horizon .1941
9 Position) Depth .1941 .1941 Soil .1043
M Slope % (In.) Struet" Consistence weMead soil
Ted Minrelo Cola Depth IN.
#,~Z
Reper,yum Odw Factors (.1946k
Site C1assiHcadon (.1948X f
C, /L r Evaluated By:
Others Phftft
❑ Other
.1976
Sqm
.1944 FtoRle
Re* Clew
Hods A LIAR
•rl 6