IPACHTE# lo-5-'D3-A` r\ Harnett County Department of Public Health 26108
Improvement Permit
A building permit cannot be issued with only an Improvemen Permit
PROPERTY LOCATION: mc~sw ~aP.P4-:i C-N~vrLCA 9~D ~11~~~~atia Qp
ISSUED TO: E~'1•S I: SUBDIVISION LOT #
NEW REPAIR ❑ EXPO ION I-] Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: Mo o Q~1 $ 'C CoLA
Proposed Wastewater System Type: C.oNVFr.rtN0r-P L--
Projected Daily Flow: GPD
Number of bedrooms: Number of Occupants: max
Basement ❑Yes >~No
Pump Required: ❑Yes ❑ No May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community --'I< Public ❑ Well Distance from well 1070 feet Permit valid for: Five years
Permit conditions: ❑ No expiration
Authorized State Agent: I &W Date: t 513bI\6 SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the iss of other permits. The permit holder is re ponsib 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 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, AM, .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 h
ISSUED TO: ~~ES2k~ 'C u~ PROPERTY LOCATION: I`~c)-~r~,N Gast ~v2c~ ~~1~ ~ayLs s~
Mdsa SUBDIVISION LOT #
Facility Type: J New ❑ Expansion ❑ Repair
Basement? ❑ Yes No Basement Fixtures? ❑ Yes No
Type of Wastewater System** Co .qE~.so'rv,t_ (Initial) Wastewater Flow: 3b6 GPD
(See note below, if applicable
l.pc, J ESC c bN Pi L- (Repair)
Installation Requirements/Conditions Number of trenches 4
Septic Tank Size 1 Q (n Q) gallons Exact length of each trench feet Trench Spacing: 9 Feet on Center
Pump Tank Size gallons Trenches shall be installed on contour at a Soil Cover. 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 C. inches below pipe
` ' Aggregate Depth: Inches above pipe
Conditions: WA'C~cL 1M-.~, M us-s l ~~t~c S url~ V-- cJy~~~, d a inches total
U -k \ Ll 'C- \ C'S I Q r_ r - - -ed **If applicable: /understand the system type rpecIll is different from the type Ipeci>red on the app&atioa. / accept the ,rpecificationr of this permit.
Owner/Legal Representative Signature: Date:
P.• w.. ` a r',h w , wanxe~. me ~unstrucvon numonzauon snau not he transferred when there is a change in ownership of the site. This
Construction Authorization is b om fiance >S th on the laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent: ek-IAs Date: 5
o ruction Authorization Expiration Date:
NTE# ►0-~- at)L1~.~ Permit # a~
Harnett County I)epal=tment of I'ilblic Health
Site Sketch
PROPERTY LOCATON: M ~cE-~ ►u~4,,,.5 la.,
ISSUED TO: SUBDIVISION LOT #
Authorized State Agent: qS 5 ouve-x'NoLXso bRy Dater 10
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Depastrnent of Environment, Health and Naluml Resources
Sheet;
Division of EnvifonmenW Health
On-Site WastewaterSecdon
Property
Pipe'
Lot
SOU.JSiTZ &VALUATION
File
Code:
for ON-SITE WASTEWATZR SYSTF,M°
Owner: Applicant:
Address Date BVatuatod: 5 )a;K) 0
Proposed Facility: 3 QBxu c~ rh S DCAP FLOW (.1949Y: -'6 0
p
LacadoQ Site pfopertYr Recorded
watt~tsupp[y
l% D lndividua< ❑ Well
❑ spring
❑ other
Evaluation Method; Boring ❑ Pit
7Auger
Type oe waslamter:
❑
cut
wage
Wustrial Procm
Mixe*
P
R
O
P 301, MORMLOOY
am
1 .1940 .1941
L Lamb
H
i
A
PRaMA FrUCTORR
"
oa
zoe
E PoaidaW
Depth
.1941 .1941
M Slope 'K
(Ia) 3tr
f
d
.1941
son
143
.1916
pe
tv
Coawde ft
Texture Mtneralo
Welled
Color
sod
Dig& IN.
3apro
Clan
L5 V NC'
X11, N P~
H=~
s~1-
Vin, s ~
5$ c~
~l 5 t~
1pdao
Mid
Repo}
aMs Other FKton (.1946k
able s ua .194!
s e
Site Ciassiflcatloa (.1948) f 5
a
ror,
c _
TAR
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Others Pre3ft
.1944 hofIM
Reap CIM