IPACHTE# /Q ,,S= agY z? Harnett County Department of Public Health 2 5 9 9 8
Improvement Permit
A building permit cannot be issued with only an Improvement Permit pp
PROPERTY LOCATION: /L ZU I 6 AA lze-cf XJ
ISSUED T0: SUBDIVISION oars: 1 LOT # l
NEW.fl' REPAIR ❑ c EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: X
Proposed Wastewater System Type: CGvLUC- Gtr
Projected Daily Flow: Q3 GPD
Number of bedrooms: 7 Number of Occupants: max
Basement ❑Yes 21-o
Pump Required: ❑Yes ❑ No 2 flay be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community (r Public ❑ Well Distance from well feet Permit valid for in- 'Five years
Permit conditions: ❑ No expiration
. 4-Z
Authorized State Agent:: jC` /..~c w•~. `/w _ Date: Q SEE ATTACHED SITE SKETCH
The issuance of this permit by the 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, .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.
ISSUED TO: c 1'. 4 CkckcC PROPERTY LOCATION: _ Lid ` cif s, 11-P4.
SUBDIVISION wo1,' eo,fc r LOT # .1
facility Type: 2-"New ❑ Expansion ❑ Repair Basement? 03 Yes No Basement Fixt re s? ❑ es ❑ No
Type of Wastewater System** Cr,'t V 't^ t (Initial) Wastewater Flow: ~ b U GPD
(See note below, if applicable
C.s- d~✓ . `."-"`Q-- (Repair)
Installation Requirements/Conditions Number of trenches l
Septic Tank Size _/00 0 gallons Exact length of each trench _Z 5'-O _ feet
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of: inches
(Trench bottoms shall be level to +1-114"
in all directions)
Pump Requirements: ft. TDH vs. GPM
ynditionA_ .c 1411, t- J-'
fc Tyr es ~c~ r u
Q ar test `o,,' It/ t ~ r, i c i e. r cs ; c~ res cr !
**If applicable: / understand the system type
Trench Spacing: Feet on Center
Soil Cover inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
6 inches below pipe
Aggregate Depth: inches above pipe
inches total
is different from the type specired on the appIication. l accept the specillinwons 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
Authorized State Agent: Date: Gtr
Construction Authorization Expiration Date: LZV/ ; °/J--
HTE# f~ kYY a 7 Permit # a S-1 19
Harnett C0'tHty Department of Public Health
Site Sketch
PROPERTY LO(ATON:
ISSUED T0:--v,~~~r SUBDIVISION C o~ K e o a 4 T LOT #
! ~1
Authorized State Agent: At ~ cw/ Date: G hl-~w
2,:0
I~
~_r3
G«
Department of Environment, Health and Natural Rmmes Sheet:
Division of Environmental Health ape
On-Site Wastewater Section Lot
SOII,ISITZ EVALUATION File
for ON-$ITa Code:
"AST1cWA
I M 313I LM
Owner Applicants
4
Address
2,6
Date Evaluated: (
Propmed Facility
Design Flow (.1949r
Froperh Size:
Locadon of S1bK
Watott Su
[
pro'" Recorded
[
i
pp
Publ
c ❑ Individual ❑
Well ❑ Spring
Evahias OU Method:
Q Auger Boring ❑ Pit
cut
Type of Wastewater:
Q' Sewage ❑ Industrial Process
Mixed
P
R
O
P
t t940
SOIL NORPHOLOOY
OTHER
L LadaaaQa Harizo~
.1941
PROFtLg plc
P. Posided DMA
a Slops 9t, 00
.1941 .1941
st
"
11941
son 1
uait
Conistaw
Taal Mtnutb
webww soli
Color aV
ftA
j (
'
❑ Other
. _
1916 .1944 ftfgi
saps„ Rant Cbw
Clan Hais ALTAR
C
Site CILWcation (.194ak
J Evehated By: ;I
Others Prent