IPACHTE# aV'128 Harnett County Department of Public Health 2 61 5 6
Improvement Permit
A building permit cannot be issued with only an Improvement Perm
ISSUED T•
C
PROPERTY LOCATION: /V C .2`f
1
cs,MS
, c
~er~
SUBDIVISION ~ iy` V
LOT #
NEW
REPAIR El
EXPANSION El
Site Improvements required prior to Construction Authorization Issuance:
Type of Structure:
M
a`
-
-
Proposed Wastewater System TyRe:
t
Projected Daily Flow:
t)-Y1
GPD
Number of bedrooms:
C
Number of Occupants:
max
Basement ❑Yes
E9' o .
Pump Required: ❑Yes
L'1 No
❑
Maa e required based on
final location and elevations of facilities
Type of Water Supply:
❑ Community
~
L✓ Public ❑ Well
Distance from well feet Permit valid for.
Five years
Permit conditions:
❑ No expiration
Authorized State Agent: / Date: (o ~/o ~z- to SEE ATTACHED SITE SKETCH
The issuance of this permit by ~tffihealtthh Departmen t in no way guarantees the issuance of other permits. The permit holder is'
s responsible for checking with appropriate goveming bodies in meeting their requirements. This
site is subject to revocation , 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, .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: ~l Ac~w~f • c~ -.bee PROPERTY LOCATION: fJ-C- 02 47
SUBDIVISION r. p.Jt-y LOT #
Facility Type: m tT "w ❑ Expansion ❑ Repair
Basement? ❑ Yes No Basement Fixtures? Yes ❑ No
Type of Wastewater System' [a~U"C,, (Initial) Wastewater Flow: 0 G GPD
(See note below, if applicable p
Q_(, IfR- 4 (Repair)
Installation Requirements/Conditions Number of trenches
Septic Tank Size 40 0 gallons Exact length of each trench .-O feet
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of: c2`4 inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
Pump Requirements: ft. TDH vs. GPM
Trench Spacing: ? Feet on Center
Soil Cover. - - inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
Aggregate Depth:
ohs: J, e ~o it s os /C Ate. r- ct~ r--1-
L r
G inches below pipe
inches above pipe
i~ inches total
**If applicable: / underrtand the system type rpeci6ed /s different from the type tpeci6ed on the app/icatian. /accept the rpecificationr of thin permit
Owner/Legal Representative Signature: Date:
A...~__:__.:__
„ .~-s«, < ~ « p, , F., ui ma meuueu me amnges, ine consrucnon Authorization shall not be transterred 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 `~f Date: l ~~fca
Construction Authorization Expiration Date: o /-r
HTE# ~6 -cam 02y 7 JE Permit # 9(- ~
Harnett ('onnty Department of Public Health
Site Sketch
PROPERTY LOCATON: /lft- .9-Y /2-7
ISSUED T0: \ r.,S .ems SUBDIVISION LOT #
Authorized State Agent: Date:
~~_l
10-r
,2 c-// a 7
Department of EwAm menk Health and Natural Resounes
Division of Emimnmentat Health
On-Site Wastewater Section
SOMME EVALUATION
for ON-SITE wA3TEWATEB SySTEM
Owner Applicant;
Address
Propvsad Facility:
Location of Sites
watts sup*
Evaluation kethad:
Type or wastewater:
Date Evaluated:
Deaigp Flow (.1949}:
Property Recorded:
Sheet:
Property ID:
Lot #
File a:
Code:
Property Size:
dC ❑ Individual Well C1 Spring
rAu ge r Boring Pit Cut
wage ❑ Industrial Process Mixed:
❑ Other
P
R
O
F
300, MORPHOLOGY
OTHER
I
L
.1940
L
ws
H
d
! 941
PROFILa FACTORS
9
a
a
PIDO& l
310" %
o
zm
Depth
(hL)
.1941
sft
w
.1941
.1941
300
.140
1916
.1944
PM&
c
Texture
Conoldom
Munk
Wdo"
Color
Sail
3Wo
Re*
CI M1
U
Clan
Haris.
A LTAX
-
F
F
Site clawcadoa (,1948)
Evahated By Others Pre=*