IPACHTE# lo-a~ a~ Harnett County Department of Public Health 2 6 1 2 5
Improvement Permit
A building permit cannot be issued with only an Improvement Permit .
PROPERTY LOCATION: Pow,oW45A
910
ISSUED TO: C u rn 2~ E1LZ-o~t~ h c> c-r, ~ SUBDIVISION CPZ p L1 NA SGj st 0 r45 LOT #
NEW REPAIR ❑ EX NSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: 'S 0 X 66^n'-~3
Proposed Wastewater System Type: Pu rn Flo Gci,vv 6 r,~, e r4 p,L
Projected Daily Flow: GPD
Number of bedrooms: 3 Number of Occupants: max
Basement ❑Yes '5< No
Pump Required:'Eges ❑ No ❑ May be required based on final location and elevations of facilities -IV Type of Water Supply: ❑ Community ;R~ Public ❑ Well Distance from well LOO feet Permit valid for. Five years
Permit conditions: ❑ No expiration
Authorized State Agent:: tZ 6115 Date: 10 SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the issuance er permits. The permit holder is esponsible 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 Improvemen ermit 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, .
with the attached system layout
1954, .1955, .1956, .1951, .1958. and .1959 are incorporated by references into this permit and shall be met Systems shall be installed in accordance
ISSUED TO: C-u4n 16E31,--o, *•4p ~Aom s PROPERTY LOCATION:
PoNOE:4LO5A 1'~p
y3~
Facility Type: 54F fl C65
_
SUBDIVISION Ccszo~~*~~• SE~,soNs LOT # 3Q
New ❑ Expansion ❑ Repair
Basement? ❑ Yes ❑ No Basement Fixtures? ❑ Yes ❑ No
Type of Wastewater System** Pu 1119 1 o
C00,G'Js~o N kI- (Initial) Wastewater Flow: 3CO GPD
(See note below, if applicable
_
Qu MP o
Co NyGrf . o tv AL (Repair)
Installation Requirements/Conditions
Number of trenches 1
Septic Tank Size tooo gallons
Exact length of each trench 1S-0 feet Trench Spacing: Feet on Center
Pump Tank Size god c) gallons
Trenches shall be installed on contour at a Soil Cover )R inches
Maximum Trench Depth of: inches (Maximum soil cover shall not exceed
(Trench bottoms shall be level to +/-1/4" 36" above the trench bottom)
in all directions)
Pump Requirements: ft. TDH vs.
GPM C inches below pipe
Aggregate Depth: inches above pipe
Conditions: \JK;ZG2 ~N% MvST gE ~rczo,~, SEpSsL syST~rn
a la
,
inches total
N-t-CGS tr\n F-"C4WP%C.Ni ON INN'S\AL OCL q\C2 ~2~A ~1i1S F1Lr~n\-5 P1>"bc j O r+ PQQF05AL'
~
'
C2,Orn ~
\PP1..\C'9sr-j'S So t1_
GC..\~tVr\ST .
**If applicable: / understand the system type specified is different from the type specified on the application. / accept the specifications of this permit.
Owner/Legal Representative Signature: Date:
This Construction Authorization is subject to?er on if the site pl n, 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 subjeSa,,compliance witlr.)k " ns o Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent:
QED Date: Cl Nvo
Authorization Expiration Date: ~ '!S~LN
HTE# ~O -5-~ 5p
--j Permit # a6t~J`
Harnett County Department of Fiblic Health
Site Sketch
PROPERTY LOCATON: PO~a,SA
ISSUED TO: cn6 NC> uo r^ SUBDIVISION CP~tA L\ N PA S L s~3a ru LOT #
Authorized State Agent. 2E.H5 ~b►-\vG -ToL'(~Q~yate:
3$~c
10 (Z-.
Department of Environment, Health and Natural Resources
Sheet:
Division of Environmental Health
Property ID:
On-Site Wastewater Section
Lot
SOMSITE EVALUATION
File
Code:
:
for ON-SITE WASTEWATER SYSTEM
Owner: Applicant:
Address: Date Evaluated: ° ►
Pro
316coacr
sed Facilit
po
y;
Design Flow (.1949x3(-
Property Size:
Location of Site: Property Recorded:
Water sup*. Public ❑ hldividual ❑ Well
❑ Spring ❑ Other
Evaluation Method: Auger Boring ❑ Pit
Type of Wastewater: S
❑ I
Cut
ewage
ndustrial Process
Mixed
P
R
O
F
1
SOIL MORPHOLOGY
OTHER
.1940
L L
Ws
H
i
1941
PROFlLB FrLCTORa
x
c i
or
zon
9 Positiow D"A
M Slope % (IM)
.1941 .1941
Str
l
1941
soil
.1943
.1976
uctura
comic o"
Texdure Miaolo
webmw
Color
soil
SAM
Clue
1 (3--41
-A~ "S)AP
ur
syrt m Other Factor, (.1946k
Site Ciasai$catlon (,1940 Q 5
Others Presat ~
s~ s
.1944 PUotllt
Re* Clan
Horis A LTA
S
S:1