IPACHTE# 1 Q Harnett County Department of Public Health 2 6 1 1 7
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: Q F-~ >,t N--\ Vp
ISSUED TO: CQ 't- e>Fntp--t> \A otw`>~h SUBDIVISION yD't2,,< ~ Av~~.~v80 LOT # ia.a.
NEWA REPAIR 14PANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: w Ffl x3a~
Proposed Wastewater System Type: Qo r.r y E. r~S ~O N F*1
Projected Daily Flow: 36C> GPD
Number of bedrooms: _ 3 Number of Occupants: ro max
Basement ❑Yes No
Pump Required: ❑Yes ~No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community Public ❑ Well Distance from well IbQ feet Permit valid for Five years
Permit conditions: A ❑ No expiration
Authorized State Agent:: p_I
The issuance of this permit by the Health Department in no way guarantees the issu
site is subject to revocation if the site plan, plat, or the intended use (hanges. The Impr
the Laws and Rules for Sewage Treatment and Disposal and to conditions of this permit..
Date: (o { 1d SEE ATTACHED SITE SKETCH
of other permits. The permit holder is responsible for checking with appropriate governing bodies in meeting their requirements. This
v~ment Permit shall not be affected by a change in ownership of the site. This permit is subject to compliance with the provisions of
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: Gurse~!=iCL~A111o VAC) s PROPERTY LOCATION: QAr, o~ 1~i
SUBDIVISION yo2~srl~Q Qi.-.P~~tCC'TtfhJ LOT # _
Facility Type: ~Ffl ~t-1~ ANew ❑ Expansion ❑ Repair
Basement? ❑ Yes -X No Basement Fixtures? ❑ Yes No
Type of Wastewater System** Co r [e'n- T ct 0 PL.- (Initial) Wastewater flow: -~4 d GPD
(See note below, if applicable
Qo rvvrGr.r'c s p si L- (Repair)
Installation Requirements/Conditions Number of trenches t-1
Septic Tank Size 1 o CS a gallons Exact length of each trench feet Trench Spacing: Feet on Center
Pump Tank Size gallons Trenches shall be installed on contour at a Soil Cover: i inches
Maximum Trench Depth of: _ G~Lljinches (Maximum soil cover shall not exceed
(Trench bottoms shall be level to +/-1/4" 36" above the trench bottom)
in all directions)
Pump Requirements: h. TDH vs. GPM inches below pipe
A regate Depth: a inches above pipe
Conditions: aT LAN 16 Ft2o~. Sys, T"(\ NO 1LtN 1 inches total
M A- CN c R.-o O ~r ti s: a a,
'*If applicable: /understand the system type sped6ed is different from the type specified on the app/ication. / accept the specificwonr of this permit.
Owner/Legal Representative i nature: Date:
This Construction Authorization is subject to rev 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 sube to compliance ith the ns o laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent: 7 \ ! Date: C
Authorization Expiration Date: e
HTE# Permit # X11 1
Harnett County Department of M-iblic Health
Site Sketch
PROPERTY LOCATON: C_r~,mesl-o tj u )i-" 'Zn
ISSUED T0: Cvrr, - t~•~sfl c~.E SUBDIVISION Yo~L~SN~2E ~tWV"SPC~1 t LOT # Val
ci
Authorized State Agent: 1) -4 r'n 'TOvv*Z)oRF Date: CzR 10
UJ N-( & tv5 1 Q) N A 1-,
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Department of EwAmnment, Health and Natural Reines
Division of Environmental Health
On-Site Wastewater Section
SOIIJSITR %VALUATION
for ON-SITZ WASTEWATZIISYSTZM
Sheet:
Property ID:
Lot
File
Code:
Owner: Applicant:
Address Date Evduatmkl
Proposed Facilltr Design Flow (.1949Y Prop" Size:
Location of Sit: Property, Recorded
wat+#tt 3upptl; PuW ❑ Individual ❑ wen ❑ Spring ❑ other
EvaltiWan MAO& Auger Boring ❑ Pit Cut
Type of W"Wwater: Sewage ❑ irldumMal Process 1141aetlE
11 -
P
A
O
F
1
1940
OIL NOAPHOLOOY
.1941
THER
PRUFRB FACTUR
E
L
9
4
LxWm
Pold"
Slope %
uS
p
Horizon
Dqd
(1a)
, .
.1941
Strvetmw
Tee h"
.1941
Coluldo a
minualo
.1942
SON 194:! .1916 1944
Wdn" soil 32pre Re*
Color IN. Ctue Horis.
boa
ChM
A LTAX
r
G `J
VFry U
Kepur yyetem Other Factors (.1946)
9 Site Classification (.1948)
Enhated By:
Others Prexrt