IPACHTE#_ Harnett County Department of Public Health 2 61 2 6
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: K-"4
ISSUED TO: P` tva l_'V1 oy C: ~C-_'y- CoMe SUBDIVISION N ii t1,65 GL~rSS nAos LOT # QCO
NEW>, REPAIR ❑ EXPANSION Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: MAH
Proposed Wastewater System Type: '~.5°Ioovcxvo N Sys-Et•,
Projected Daily Flow: L-) 1% GPD
Number of bedrooms: H Number of Occupants: g max
Basement ❑Yes X No
Pump Required: ❑Yes ❑ No May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community ~K Public ❑ Well Distance from well 1CC feet Permit valid for. Five years
Permit conditions: _ ❑ No expiration
Authorized State Agent.: Nl~ c?&st'~s _ Date: ~ 1\ t SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the issuance other permits. The permit holder is responsible 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 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, .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: ~__11 N E GC,xsv(` p6v. Cook PROPERTY LOCATION: Nwy
SUBDIVISION NWrc Ur,Es Ca.al.%Wk S, -LOT # CO
Facility Type: MP -41 , laor,E d x10 New ❑ Expansion ❑ Repair
Basement? ❑ Yes ~x No Basement Fixtures? ❑ Yes XNo
Type of Wastewater System** a,S°lo '0.E,0\-J<'c f ,1 sy a~~N, (Initial) Wastewater Flow: 4'4 GPD
(See note below, if applicable
a5'z)/o 9'r--Q vc-'S r S~s'CEth (Repair)
Installation Requirements/Conditions Number of trenches 1
Septic Tank Size VBQC) gallons Exact length of each trench 'Ac>0 feet
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of: 1~Z inches
(Trench bottoms shall be level to +1-114"
in all directions)
Pump Requirements: ft. TDH vs. GPM
Trench Spacing: Feet on (enter
Soil Cover: inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
inches below pipe
inches above pipe
- inches total
Aggregate Depth:
Conditions: \J pm- C L\,4 CS rRust gE }()I~opm SE,jZS \.C. SyS;Fir\
try\t_TC\~~j 14'"j~rL(ZdNI ON ,Nl~\R) nr)_ Pt~gD~n ~nceL
**If applicable: l understand the system type specified is different from the type specified on the application. / accept the specifications of this permit.
Owner/Legal Representative Signature:
This Construction Authorization is subject to revo if the site
Construction Authorization is sukct to compliance witlithe p
Date:
or the intended use changes. The Construction Authorization shall not be transferred when there is a change in ownership of the site. This
aws and Rules for Sewage Treatment and Disposal and to the conditions of this permit. SEE ATTACHED SITE SKETCH
Authorized State Agent: Date: 6 s\ 10
(onstru ' Authorization Expiration Date: Ti IS
HTE# 10- s-aLj 5)) Permit # 34 )
Harnett County- Department of ll~iblic Health
Site Sketch
PROPERTY LOCATON: N
ISSUED TO: P~ - Gel3v C,'D -4 . comae :BDIVI'SION N Psi vr24s ~,-a oscj2z~,~J j LOT
Authorized State Agent: ~ .1v~rL Date: Q
t
Q~C"
G~~
Department of Environment, Health and Natural Resources
Division of Environmental Health
On-Site Wastewater Section
SOIIJSITZ EVALUATION
for ON-SITZ WASTEWATER SYSTEM
Sheet:
Property ID:
Lot
File
Code:
Owner. Applicant;
Address: Date Evacuated: ~o
Pmpose FWWty: y~ tin, Deslp Flow 1949): L Property Size:
Location of Site: Property Recorded
water Supply: tPubiic ❑ Mdividuac ❑ WeH ❑ Spring ❑ Other
Evaluation Method: Auger Boring ❑ Pit Cut
Type of Wastewater: Sewage ❑ Industrial Process Mixed
P
R
O
P
1
1940
OIL titORPHOLOOY
.1941
THER
PROFur 3
CTOR
L
S
a
i.mdncape
Position/
Slope's
Horizon
Dq* .1941 .1941
(h) sbuch" Connidem
Texh" Miumlo
.1942
sod
webmw
Cola
1443
soil
DiVA IN.
.1956
Sapro
Clan.
.1944
Raw
Haut.
Pmme
chw
AL1`Alr
(t
363 X C_ {L 51
-
0
C~
58, sG2- U`rz . S:5 te
L Repaw `Jymm Other Factors (.19 46~
Site Clam0cation (.1948X t'S
Evalusted By- C
Othas