IPACHTE# 10'5 aY+so~ Harnett County Department of Public Health 26107
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: C`>>c„1-,7orvC.rz~ ZC
ISSUED TO: 0 SUBDIVISION P svs Qa~ LOT # 565
NEWW'I< REPAIR ❑ F~(PANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: ~~c~'~~ )
Proposed Wastewater System Type: Bu-~ a Ce'H A'- L
Projected Daily Flow: GPD
Number of bedrooms: 3 Number of Occupants: - max
Basement ❑Yes No
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 in feet Permit valid for. Five years
Permit conditions: ❑ No expiration
Authorized State Agent::~~ Date: 5 I Ztg 1 f d SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the issuance er permits. The permit holder 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 rmit 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 .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 T0: PROPERTY LOCATION: we"L, Q-0
SUBDIVISION Pact, LOT # IS-5
Facility Type: New ❑ Expansion ❑ Repair
Basement? ❑ Yes No Basement Fixtures? ❑ Yes '1~Q'No
Type of Wastewater System** Ps t P \ Cam, r, r sti , ti ~t }3 0 GPD
(Initial) Wastewater Flow:
(See note below, if applicable
~)v C-11? -7e Co" 'Vc_,~ 5 ; N er-"J ~'.t_ (Repair)
Installation Requirements/Conditions Number of trenches QL
Septic Tank Size goo gallons Exact length of each trench S
Pump Tank Size t.o t~ gallons Trenches shall be installed on contour at a
Maximum Trench Depth of. 3
(Trench bottoms shall be level to +/-1/4"
in all directions)
Pump Requirements: ft. TDH vs. GPM
feet Trench Spacing: 3 Feet on Center
Soil Cover: c3 inches
inches (Maximum soil cover shall not exceed
36" above the trench bottom)
inches below pipe
Aggregate Depth: inches above pipe
Conditions:
L~cs lanct~P~~~ ~y~~~~7_ s; Q~£rz L inches total
*If applicable: /understand the system type specified is different from the type specified on the application / accept the rpecifUtionr of this permit
Owner/Legal Representative, Sj nature: Date:
This Construction Authorization is subject to revo ' if the ite p lat, 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 subj ompliance wi e p f the s and Rules for Sewage Treatment and Disposal and to the conditions of this permit. SEE ATTACHED SITE SKETCH
Authorized State Agent: vw" : Date: 5
Constr Authorization Expiration Date:
HTE# Permit 14`?
Harnett County 1_)epal-tment of 1"liblic Health
Site Sketch
PROPERTY LOCATON: r~~c zC`~C-~JGt V-9
ISSUED T0: c L w ~o - S SUBDIVISION Pad ,mss Q c~, LOT #
Authorized State Agent: t2k~r)S (g L C 'faLYSDC~ Date: ~n n
Pv
t
4,
~h x~o
V~
Department of Environment, Health and Natural Resources
Division of Environmental Health
On-Site Wastewater Section
SOEUSIT)Z EVALUATION
for ON-SITE WASTEWATER SYSTEM
Sheet:
Property 1D:
Lot:
File
Code:
Owner. Applicant:
Address Date Evah>atod:
Proposed Fatality: c» c t<- Design Flow (.1949): h~?
Locadon of Sibs Properly Recorded: '
water rSupp[j f e ❑ Individual ❑ well
Evaluation Method: Auger Boring ❑ Pit
Type of wastewater: ,Sewage [I Industrial Process H
Property Size:
❑ Spring ❑ Other
cut
mixed
P
R
O
F
1
1940
011. MORPHOLOOY
.1941
THER
PROFtLB FAC 1 ORS
L
E
M
Leap
PoridoW
Slope %
Horim
Dq* .1941 .1941
(k) Strvohow Conddam
Texh" MIUM10
1941
sod
webmw
Color
1O3
soil
QY,
.1916
SWO
Cler
.1944
Re r
Harts.
Floft
Claw
RLTAR
VST
eeepnr syrtem Othar Factors (.19462
SY6T Site CIMARcation (.1948X
J ~ a gar Evahated By oo
Others Preenl: