IPACHTE# ► 0 Harnett County Department of Public Health 26128
Improvement Permit
A building permit cannot be issued with only an Im rovement Permit
PROPERTY LOCATION: Acts P_o
ISSUED T0: yf-- CurnrnsNC. --5
SUBDIVISION ~N-sNk~gx~ LOT #
LAO
NEW 'X REPAIR [I
Type of Structure: O (,u`1_ EXPA-ON El Site Improvements required prior to Construction Authorization Issuance:
SA x55
Proposed Wastewater System Type: a.5% S~~o~c,~or. S JszFsn
Projected Daily flow: 3 6 C) GPD
Number of bedrooms: 3 Number of Occupants: max
Basement ❑Yes No
Pump Required: ❑Yes No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community Public ❑ Well Distance from well ',OO feet Permit valid for. Five years
Permit conditions:
❑ No expiration
Authorized State Agent:: G1~3 Date. Fo
The issuance of this permit by the Health Department in no way guarantees the iss other permits. The permit holder is res nsible for checking with appropriate governing SEE bodies in meetin ATTACHED g thei SITE SKETCH
r requirements. This
site is subject to revocation if the site plan, plat, or the intended use changes. The Improve em 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, J958. 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 T0:NE~~~ Cam, n,c~,,,vC,S PROPERTY LOCATION: S`'1aa,~.s
SFOL~°1 xss~ SUBDIVISION R~~HFOcz~ LOT # ►-40
Facility Type: New ❑ Expansion ❑ Repair
Basement? ❑ Yes ~ No Basement Fixtures? 11 Yes No
Type of Wastewater System** cis°/a Sl ~~c-~ n N S S~ EM (Initial) Wastewater Flow: C7 GPD
(See note below, if applicable
2.6°°f o
~~oucr,~o r.1 ~~5: Crn (Repair)
Installation Requirements/Conditions
Number of trenches
Septic Tank Size v6 end gallons
Exact length of each trench S(Z) feet
Pump Tank Size gallons
Trenches shall be installed on contour at a
Maximum Trench Depth of ~"-O inches
(Trench bottoms shall be level to +/-1/4"
in all
directions)
Pump Requirements: ft. TDH vs.
GPM
Conditions: "4qi E
L*%^c G t,~v-t
'~-'F- t0' =QafY. S ~\c-
>c~ 0N ~N 1 Tab t 4Q qj~1'J~"
" F-r'
Trench Spacing: 9 feet on Center
Soil Cover. inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
inches below pipe
AggrT° Depth: inches above pipe
inches total
**If applicable: / ucdeatacd the s1wein type rpecired it di//erect lrom the type .rpecifed oc the app/ication. / accept the .rpeci6cuionr o(thit permit.
Owner/legal Representative Signature: Date.
This Construction Authorization is subject_t vocaton if the site pan, 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 su tI compliant tt ions o e Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent: Date: G
Constr n Authorization Expiration Date: _
HTE# Permit # aC}_qN,'?
Harnett (county Department of Public Health.
Site Sketch
ISSUED TO:
Authorized State Agent:
PROPERTY LOCATON: MP~RY`S RD
_ SUBDIVISION bty," ) \ LOT # LA D
Date: \ \ d
gala ~,6OVG>~dsJ
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Department of Emirunnient, Health and Natwal Remma
Division of Environmental Health
On-Site Wastewater section
SOnJSrM &VALUATION
ror ON-SIT1E wASTIl:WATIgS SYSTEM
Owner: Applicants
Addrac Date Evaluated: 6~,Vf) n
Proposed FudltT a lOz OfOv"'N Design Flow (.1949): 3 t
Location of Shat Pro" Recorded:
water bp* Public D Individual ❑ Well
Evaluation Method: Auger Boring El pit ❑
Type of Wastewater Sewage ❑ Industrial Process
Sheet:
Property ID:
Lot M:
File N:
Code:
Property Size-
11 Spdng ❑ Other
cut
mb"
P
It
O
P
1
1940
OtL NORPHOLOOY
.1941
THER
PROFILa FACTOR
L
B
Loom apr
Poei"
Slops %
Harizom
Depth
(14)
.1941
stucure
Togwe
.1941
co"da"
Hinrnb
.1942
sail .100 .1936
wetmw &d swe
Color IN. Ctm
.1944
Rend
Hoot.
Prot114
OW _
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b
O 3c)~
G s
~~~K$
I
20
3f?''1e
s
r4 5!5)Nr)
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e
Site ClasM ation (.1948X B
Evaluated B):
Others Rents 1
t so ao