IPACHTE#_Zc-S-- 2-113?,Z Harnett County Department of Public Health 2 5 9 9 0
Improvement Permit
A building permit cannot be issued with only an Improvement ermit
jj PROPERTY LOCATIO ' M: t_,"% fc r.w
ISSUED TO: ~1`anc , xi,. SUBDIVISION LOT #
NEW g REPAIR ❑ r EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: 5'-F, b ~6 a
Proposed Wastewater System Type: . .,t
Projected Daily Flow: fo _ GPD
Number of bedrooms: Number of Occupants: C max
Basement ❑Yes 21o
Pump Required: ❑Yes lo ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community E?`~_Public ❑ Well Distance from well feet Permit valid for f71-1ve years
Permit conditions:
❑ No expiration
Authorized State Agent: l Date: SEE ATTACHED SITE SKETCH
The issuance of this permit b e Health Department in n ay 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, .19% 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: k;14D';Vy- PROPERTY LOCAT N: 1r (1t c• r~•
SUBDIVISION LOT #
Facility Type: 2-New ❑ Expansion El Repair
Basement? 03 Yes No Basement Fixtures? ❑ Yes ❑ No
Type of Wastewater System" 7- t! << f r~eA_ (Initial) Wastewater Flow: G GPD
(See note below, if applicable
/'-,,J1U
c : yi &,p c.+. (Repair)
Installation Requirements/Conditions Number of trenches
Septic Tank Size Pq C) gallons Exact length of each trench 7r feet
Pump Tank Size gallons Trenches shall be Installed on contour at a
Maximum Trench Depth of: _'3 0 inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
Pump Requirements: ft. TDH vs. GPM
t / (T.([ C v+ Cd , ,mot. J-/„
c~t-- S-
inches below pipe
inches above pipe
inches total
**If applicable: /understand the system type specified is different from the type specified on the app/ication. / accept the soecircatioar of this 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 change in ownership of the site. This
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. SEE ATTACHED SITE SKETCH
Trench Spacing: Feet on Center
Soil Cover: /8 inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
Aggregate Depth:
1t - - 1-1_^-J Oita J
Authorized State Agen~r'~_~_~~,~ Date:
Construction Authorization Expiration Date: 6 /a -'-J "
HTE# /L- - XY.7 l2 Permit # 02 S-7 F6
Harnett County I)epa1ltlent of I'iblic Health
Site Sketch
PROPERTY LOCATON:
ISSUED TO: c- c . e^I SUBDIVISION LOT #
Authorized State Agent • Date: C 4, Z°! c~
r
l f~
r
Department of Environment, Health and Natural Resources
Shed:
Division of Environmental Health
Property 1D:
On-Site Wastewater Section
Lot
SOIIJSITE EVALUATION
File M:
Code:
for ON-SITE WASTEWATER SYSTEM
Owner: Applicant: _
Address: Date Evaluated: ~z ~zOf
Proposed Facility, Design Flow (.1949): Property Size:
Location of Site; Property Pccorded:
Water suppb; d-f ❑ bdividual ❑ Well ❑
ti
Spring ❑ Other
Evaluadon Method:
ger Boring ❑ Pit cut
T
e of Wastew
te
S
yp
a
r:
ewage ❑ Industrial Process Mixed
P
R
O
P SOIL MORPHOLOGY
OTHER
1 .1940 .1941 PROFILE FACTOR
S
L L xlec" Horizon
.1941
9 Position/ Depth .1941 .1941 soil
M Slope % (Id) Struch" Coedstmq wetnaarr
1943
.1956
.1944 Frof>b
Toxftre Mir wolo Cola
soil Sol"
IN. Cl
w
Restr CtM
Horis ALTAR
E)
- - - - - - - - - - -
Sydow Other Factors (.1946)
s stars
Site C1aWcation (.1948) f`
Awdlabl4 3 a 1943
.
System e l d Evaluated By: d1--
`
sh. LT,ut _
Other Prexnt -