IPACHTE# Harnett County Department of Public Health 2 61 2 4
Imurovement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: QcµoErzaS~.~clc,sL
ISSUED TO: Ar~GGLt-~, L-I0N SUBDIVISION Cwzo~~N~ S~,sty,~ LOT # SN
NEW>, REPAIR ❑ EINSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: SC-'0 ~S3 n5`1
Proposed Wastewater System Type: CU N -4 ErfS,~) N AL
Projected Daily Flow: 3 GPD
Number of bedrooms: 3 Number of Occupants: JG max
Basement ❑Yes No
Pump Required: ❑Yes XNo ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community X Public ❑ Well Distance from well t l!) feet Permit valid for: Five years
Permit conditions: ❑ No expiration
Authorized State Agent:: 7s\_~ n C-'r15 Date: » a SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the issuance er permits. The permit holderlis r onsible 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 mit 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: P~cv ~Ca_ cam, Lxp ~ PROPERTY LOCATION: lS'o rr4~ E12OS A, t,c.~ t~
-24 , SUBDIVISION GAfl.p L-) r4 tk St~.se,v LOT # B 17
Facility Type: S~ ~3 - 1 / 'X New ❑ Expansion ❑ Repair
Basement? ❑ Yes 'P!r, No Basement Fixtures? ❑ Yes 'KNo
Type of Wastewater System** CO- (Initial) Wastewater Flow: 3 ~ P GPD
(See note below, if applicable
o ^t,f & -'r=-, v N S,1-- (Repair)
Installation Requirements/Conditions Number of trenches
Septic Tank Size L O O a gallons Exact length of each trench ► sO feet
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of., c~-''r-3o inches
Pump Requirements: ft. TDH vs.
(Trench bottoms shall be level to +/-1/4"
in all directions)
GPM
Trench Spacing: Feet on Center
Soil Cover: 4 finches
(Maximum soil cover shall not exceed
36" above the trench bottom)
Conditions: cnJSZ Aggregate Depth:
qDE 10 ~aor~. SE U Sys i~
inches below pipe
inches above pipe
1 inches total
**If applicable: l understand the sy tem type specihed if different from the type specified on the application. / accept the fpec1f1cationr of this permit.
Owner/Legal Representative Signature: Date
This Construction Authorization is subject to revoca a site plan, lot, 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 subje to %mpliance with! pro, ~t6e and Rules for Sewage Treatment and Disposal and to the conditions of this permit. SEE ATTACHED SITE SKETCH
Authorized State Agent:
RG~S Date: G1 "I I6
orization Expiration Date:
HTE# l0 Permit # a67a~
Harnett County I)epartment of Public Health
Site Sketch
ISSUED T0: Lti 4 N PROPERTY LOCATON: Po ^~ea0pl ~2N N l-
SUBDIVISION Cameo 4N SFASont LOT # g-~
Authorized State Agent
Q (~5 Lev `ro L~ Date:T~\ 0
!N~~
t c
PoNO~sr~. fi~~y.
Department of Environment, Health and Natural Resources
Division of Environmental Health
On-Site Wastewater Section
SOQJSUZ EVALUATION
for ON-SITE WASTMATES SYSTEM°
Owner. Applicant:
Addy w. Date Evaluated: q f u
Proposed Facility: Design Flow (.1949): 3.0
Location of Site: Property Recorded
Wahx Supply lic ❑ Individual ❑ Well
Evaluation Method: pse, ger Boring ❑ Pk ❑
Type of V11w water: a ge ❑ Industrial Process
Sheet:
Property ID:
Lot
File
Code:
Property Size:
❑ spring ❑ other
cut
Mb"
P
R
O
F
1
1940
OIL NORPHOLOOY
.1941
THER
PROFILE FAR7tOR3
L
9
0
Lmxbc" Horizon
Po°idod Depth
Slope % (In)
I
.1941
stuehwl
Texhae
.1941
Con dam
Mln to
.1941
suit
webmw
Color
.1443 .1956
soil swe
IN. Clue
.1944
Redr
Horis
PMfllr
Clan
• LTAR
1
N,
4-L-111
G s Yt ~
V," Mar Factors (.1946k
Site ClauiHcadon (.1948X ;5
Evahnted By:
' Othas Pnaenh
C.~~ 30