IPACHTE# 10-5-'~~LACV)
Harnett County
Department of Public Health
2 61 1 9
Imp
rovement Permit
A building permit cannot be issued with only an Improvement Permit
ISSUED TO: ~vs-5 tt_J
$
y NDll2GV WA
PROPERTY LOCATION: C Q
SUBDIVISION ~.o C`1c.~.P,G aaAE
LOT #
NEW REPAIR ❑
Type of Structure: SF 0 (
EXP SIGN ❑
X05°►
Site Improvements required prior to Construction Autho
rization Issuance:
Proposed Wastewater System Type:
n yE~ a : ~o w P L_
Projected Daily Flow: `3E, O
GPD
Number of bedrooms: 3
Number of Occupants: C>
max
Basement ❑Yes No
Pump Required: ❑Yes No
❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Communi
ty Public ❑ Well Distance from well 1007 feet Permit valid for
214ive years
Permit conditions: `
❑ No expiration
Authorized State Agent.: j~ i HS Date: C, S L 0 SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the issua other permits. The permit holderlis re nsible 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 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 Bgilding 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: J u5l N11r PROPERTY LOCATION: $2P<-- ' p.N E
5 (65 SUBDIVISION RXiS5 r-,, .AE Qx,,Q,E -LOT # G
facility Type: ci \ New ❑ Expansion ❑ Repair
Basement? ❑ Yes No Basement Fixtures? ❑ Yes No
Type of Wastewater System** C o N is .r< , 0 "AL_ (Initial) Wastewater Flow: 3(.0 GPD
(See note below, if applicable
Co" -4 E_r"N \ O r-,J PAL (Repair)
Installation Requirements/(onditions Number of trenches a
Septic Tank Size 1.CDo y gallons Exact length of each trench -IS- feet
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of. 1Q,-3 inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
Pump Requirements: ft. TDH vs. GPM
Conditions: Wa~Fsa.L~ t~~Ctlys~ ~E SEA>-S -%C, 4J jS'sEr\ p
N1 P~ ~t ~ccz~c~r~ - ~v v 'N o, 4_ o a_ QJ&0 A, a..
inches below pipe
gate Depth:- inches above pipe
1~FS inches total
**If applicable: / understand the s tem type specified is dilferent from the type specilled on the app/ication. / accept the specipcationr of this permit.
Owner/Legal Representative Signature: Date:
I
This Construction Authorization is subject to revo 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 subj t t compliance t s o Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent: P 1~S Date: 6
Authorization Expiration Date:' "6
Trench Spacing: 9 Feet on Center
Soil Cover. C - 9 'Inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
HTE# ] -5 - , ~N,°\ Permit # 1~ l )i
Harnett County Department of F' bl i c Health
Site Sketch
ISSUED TO: Z
Authorized State Agent:
PROPERTY LOCATON: ~)nxvs
_ SUBDIVISION Voss ne V-Pc S&) .NE LOT # b
-jd~oocp ate: I l0
I
X50
Department of Eaviroumgnt. Health and Natural Resources Sheet:
Division of Environmental Health Property ID:
On-Site Wastewater Section Lot
File N:
SOEUSITE EVALUATION Code:
for ON-SITE WASTEWATER SYSTEM
Owner: Applicant:
Address: Date Evaluated: P
P
Proposed Facility: 3 a _ Design Flow (.191 y
Property Size:
Locatiou a( Site Praout r' Recorded.
water 3uppi Publk ❑ Individual ❑ Well
D Spring
❑ Other
Evaluation Method: Auger Boring ❑ Pit
Cut
Type of wastewater Sewage ❑ Industrial Process
Mixed
P
It
0
F SOQ. N10"HOLOOY
OTHER
1 .1940 .1941
PRaFILB FACTOl1~
Horizon
~f
1942
9 Posi
Dq
& .1941 .1941
4 Slope 'n (ter) Sw
l
h
Sod
.1943
.1976 .1944
Prof11r
is
n
Cowi+Rm"
Taxwe Minnie
webmw
Color
soil
IN,
S"M Redr
Clan Hail
CbW
A LTM
•o
*LT ~ yY~ Other Factors (.1946k
Site ClaasiHcation (.1948k
Evaluated By: ~
Others present:
~ v