IPAC RHTE# 1 Q-- S-a AM1 Q Harnett County Department of Public Health 2 61 1 2
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
ISSUED T0: sN C-.ss I--P~s p PROPERTY LOCATION: t1J gt§eg t 4
C_;1J SUBDIVISION ~Oa CS'c Qp,.F LOT #
NEW X REPAIR ❑ EXP 4SION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: _sGS~ Proposed Wastewater System T Type: Pur„e"'o O-
YP REtJV US to ~ Svs 5Et4\
Projected Daily Flow: GPD
Number of bedrooms: Number of Occupants: max
Basement ❑Yes X No
Pump Required:XlYes ❑ No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community, Public ❑ Well Distance from well 10 d feet Permit valid for. Five years
Permit conditions:
❑ No expiration
Authorized State Agent:, v E`cjS Date: Wre SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the iss ther permits. The permit hole for ch ecking 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 Improvem 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, AN, .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: Lf~.~+o PROPERTY LOCATION:
v¢5E:2y ~D
SUBDIVISION ~s-T LOT # 1"$
Facility Type: -S'--'fl 00 ~ALAn' New ❑ Expansion ❑ Repair
Basement? ❑ Yes ~k No Basement Fixtures? ❑ Yes XNo
Type of Wastewater System" Qo-+ \A a --LVX,, Q~uc,-~tor1 Sys~~~ (Initial) Wastewater Flow: X40 GPD
(See note below, if applicable
Pv 107- WT-/o ~ga _ ~556m (Repair)
Installation Requirements/Conditions Number of trenches
Septic Tank Size yo 0<D gallons Exact length of each trench ~35 feet Trench Spacing: ~ Feet on Center
Pump Tank Size ),OO U gallons Trenches shall be installed on contour at a Soil Cover:_ inches
Maximum Trench Depth of:.ali_ 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
NE rn~ 5 5 Aggregate Depth: inches above pipe
Conditions: p+s~~A. F~£ 1 ;lqr, S E~P'~ Sys ' EM N o C~ s~5 inches total
t~ PrJ ~GNti2GPvC;\1 Otl~M\~l~l OCL~EPp\Q FP. ~la~ ~C ~4~5£D ON TQOPdSq.~ M
RPpL~c.ps..f~5 Sotiy. ~oa.,s,vL, ts~ ,
'`If applicable: / nnderrtaad the system type specified is different from the type specified on the application. / accept the rpeci6cationr of thi permit.
Owner/Legal Represen Si nature: Date:
This Construction Authorization is subject to revoc ' f the Ian, plat, 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 s1iWect to compliant ith s he laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent: X135
7 Date: > >4
Const ion Authorization Expiration Date: C
HTE# Id S~ ~p~ l Permit # DiI
Harnett Connty Department of Miblic Health
Site Sketch
PROPERTY LOCATON:_ N Qe§E -1
ISSUED TO: C NEB ~ o o ~ 6.,! SUBDIVISION Fat Es-~ 4 awe LOT # 3
Authorized State Agent t: -~-oLx~gOt) Date:
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Department of Emkonment, Health and Natural R"mrm
Division of Emironrnental Health
On-Site Wastewater Section
SOILISTTE EVALUATION
for ON-SITE WASTEWATER SYSTEM
Owner. Applicant:
Address:
Proposed Facility:
Location of Site:
Water Supply;
Evaluation Method:
Type of Wastewater:
Date Evaluated:
Design Flow (.1949):
Property Recorded:
❑ Public ❑ Individual ❑ Well
❑ Auger Boring ❑ Pit ❑
❑ Sewage ❑ Industrial Proms ❑
Sheet:
Property ID:
Lot
File
Code:
Property Size:
❑ Spring ❑ Other
cut
Mixed
P
R
O
F
1
L
E
it
1940
LAxh"ps
position/
Slope %
orizon
Depth
(In.)
OIL MO"HOL.OOY OTHER
.1941 PROFILE FACTORS
.1941
.1941 .1941 Soil 1943 .1936 1944 Profl1e
Stmctorod Comiatance weta"d sod Sapro ReW Claw
Tomb" Minxab Color IN. Clan Horn R LTAR
5
a
p~6
G S v c~2- Us)N
3
Ma Factors (.19467
Site Classification (.19487
Evaluated By:
Others Present: