IPACHTE# io -s-ay3 Harnett County Department of Public Health 2 6 1 0 3
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: a ~~c~-~ucR N~
ISSUED TO: M`Je C,0 rY.2VL~ tnN SUBDIVISION \L LOT #
NEWX REPAIR ❑ EXPANSION ❑
Type of Structure: SVIZ) ( "q CSC Site Improvements required prior to Construction Authorization Issuance_
Proposed Wastewater System Type: CnNIr gryr-JL
Projected Daily Flow: 3 6 O GPD
Number of bedrooms: Number of Occupants: C" max
Basement ❑Yes X No
Pump Required: ❑Yes -ff ~-No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community -P~- Public ❑ Well Distance from well feet Permit valid for five years
Permit conditions: ❑ No expiration
Authorized State Agent: ~p.5 Date: 10 SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the issua ther permits. The permit holder is resp nsible 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 Improvemen 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: 1~1se C-0~J CLV C? 1-i PROPERTY LOCATION: S~wv~2~s+p2~tC=
SUBDIVISION -I, f; S v, n V~ LOT # 9_
Facility Type: SFflCyL~~xS(-~ New El Expansion ❑ Repair
Basement? ❑ Yes ~ No Basement Fixtures? D s _:x No
Type of Wastewater System** tri ty~, L (Initial) Wastewater Flow: ~ O GPD
(See note below, if applicable
C°~'~~~ahtP►- (Repair)
Installation Requirements/Conditions Number of trenches 3
Septic Tank Size IC7oO gallons Exact length of each trench 50 feet Trench Spacing: Feet on Center
Pump Tank Size gallons Trenches shall be installed on contour at a Soil Cover: G'-v,~►`~ inches
Maximum Trench Depth of. 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
Conditions: wr.-~GcZ L-1- c F ~t,~ Sys L ~jy~~ d 1 inches total
V-es~~-~~Fs P'1tH ' - Qopc'>A 0J 1u ~-c►P~~~ ~~pa~~ ~,or>~.
**If applicable: /understand the system type specified is different from the type specified on the app/ication. / accept the specifications of this permit
Owner/Legal Representative Signature: Date:
This rnnctmrtinn Authnn-tine i, -hi- t„ .a.... it i _ _i_.
r• r•°~ 11111 - - --6- urc wnwuwun nummaauon snap not De cransterrea wnen mere is a change in ownership of the site. This
Construction Authorization is subject to complian the pro ' i s of aws and Rules for Sewage Treatment and Disposal and to the conditions of this permit. SEE ATTACHED SITE SKETCH
Authorized State Agent: Date: d5 1 b
Constru Authorization Expiration Date: 1,.5
HTE# Ib -5- a~375 Permit # Q.6103
Harnett (bounty Department of Public Health
Site Sketch
PROPERTY LOCATON: S iwyE 1-NMr F-
ISSUED TO: M C,oa~ ~~y~S SUBDIVISION IIaL- Sor-%n,-C LOT # `8-&-
Authorized State Agent:
ALPr rA ~ pY2,
Date:
cower
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Department of Environment, Health and Natural Resom m
Division of Environmental Health Sheet:
Sheet ID:
On-Site Wastewater Section Lm erty
SOLUSUZ EVALUATION File a:
for ON-SITE WASTEWATZB S"TBM Code:
Owner Applicant;
Address: Date Evaluated: 51!DZ},4
Proposed FadfitT DcApFlow (.1949): O c1r) Propertp Size:
Location of Situ FropertY itecorded
Water Eupp i~c ❑ Individual Well ❑ Spring El Other
Evalu~ian Method: rAuga Boring ❑ Pit cut
Type of Wastmater: wage ❑ Industrial Pmcess Mud
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.1940
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DqA .1941
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.1941
son Iola .1956 .1944 ftft
wdummd sod SWo Real Cho
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Site Clauiflcadou (.1948)
Others Pre3ft
3 x S 4.,~ -36',