IPACHTE# 10 -,S-- ay 37o Harnett County Department of Public Health 2 5 9 8 7
Im rovement Permit
A building permit cannot be issued with only an Improvement Pumit
.6, 1 PROPERTY LOCATION: ~'n i e css~-
ISSUED TO- 57 T L o-n C-• ~ tJ d er 1 SUBDIVISION _ r ts~~"-~ d~Fl` a..1 LOT # /0-?
NEW REPAIR ❑ EXPANSION ❑
Type of Structure: Site Improvements required prior to Construction Authorization Issuance:
~ ~ Yo
Proposed Wastewater System Type: c2-,f f .
Projected Daily Flow: _ GPD
Number of bedrooms: 3 -Number of Occupants: max
Basement ❑Yes E ' o
Pump Required: ❑Yes 54o ❑ Mae required based on final location and elevations of facilities
Type of Water Supply: ❑ Community Public El Well Distance from well feet Permit valid for 2"Five years
Permit conditions:
❑ No expiration
Authorized State Agent.: G Date: L l SEE ATTACHED SITE SKETCH
The issuance of this permit a Health 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 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: 1-5 PROPERTY LOCAT N: i Cpla a ,.w-,ZCJ
SUBDIVISION LOT #
Facility Type: S~ ID [New ❑ Expansion ❑ Repair
Basement? ❑ Yes E' No Basement Fixtures? ❑ Yes ❑ No
Type of Wastewater System" 227. A-4 e., (Initial) Wastewater Flow: _36 U GPD
(See note below, if applicable
-J~_04,_ (Repair)
Installation Requirements/Conditions Number of trenches
Septic Tank Size gallons Exact length of each trench /5`0 feet Trench Spacing: 9 Feet on Center
Pump Tank Size gallons Trenches shall be installed on contour at a Soil Cover: / 8 inches
Maximum Trench Depth of. '2C`~ 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
(onditions: 11, &C""._ ~r c~J joy inches total
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the system type specified is different from the type specified on the app/ication. / accept the specircationJ of thi 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
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
e in ownership of the site. This
SEE ATTACHED SITE SKETCH
Authorized State Agent:
Date:z R~/ G
Construction Authorization Expiration Date: C z ~~l!
HTE# /0, - s = Aq3? c Permit # R Pj
Harnett county Department of vvwic Health
Site Sketch
PROPERTY LOCATON:
ISSUED T0: SUBDIVISION LOT
Authorized State Agent: K Date: 2 2G~~
15-~
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Department of Environment, Health and Natural Resources Shed:
Division of Emrironmentat Health
On-Site Wastewater Section L Property ID:
Lot 1!:
SOIIJSTTE EVALUATION File
for ON-SITE WASTEWATER SYSTEM Code:
Owner. Applicant:
Address; Date Evaluated: d Zt// 4
Proposed Facility: Desigp Flow (.1949): Property Size:
Location of Site: Property Recorded.
Watt 3upptjr lic ❑ ladividual ❑ Well ❑ Spring ❑ Other
Evaluation Method: 41culm R~A ger Boring 0 Pit ~ C`11t
Type of Wastewater: g e ❑ Industrial Process Mixed
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PROFILE 8AC
.1941
soil .1943
Webmw soil
SYaram Other Factors (.1946
Site CluW!"don (.1948k r
Evaluated By G
Othm Premme
1936
.1941 plreft
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Haas A LTAX
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