IPACHTE# toHarnett County Department of Public Health 26134
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: Po-g&'0Sp (Zq
ISSUED TO: G r2.EG C~-I R..-IST 1AN SUBDIVISION f r F~E~Y LOT #
NEW REPAIR ❑ EXPANSION Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: MN" r~~
Proposed Wastewater System Type: o 1PC--0 uclt,ON S~txC-M
Projected Daily Flow: 3 ~O GPD
Number of bedrooms: Number of Occupants: max
Basement ❑Yes No
Pump Required: ❑Yes ---ISI No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community Public ❑ Well Distance from well t C~ b feet
Permit conditions:
Permit valid for -11-N 'e years
❑ No expiration
Authorized State Agent::~~ SEE ATTACHED SITE SKETCH
Date: G ~-7 lD
The issuance of this permit by the health Department in no way guarantees the issuance o rmits. The permit holder is responsible for checking with appropriate governing bodies in meetng their requirements. This
site is subject to revocation if the site plan, plat, or the intended use changes. The Improvement Perm 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 T0: G2Eq
, -N s-c.y~N PROPERTY LOCATION: ~oNa~i11~5P ~i~
SUBDIVISION l-t~Cf3F~Gt LOT # -'-I
Facility Type: Y') F1 N ko r ~,v~I ) X New ❑ Expansion ❑ Repair
Basement? ❑ Yes X No Basement Fixtures? ❑ Yes No
Type of Wastewater System** 3 S-Zo ~EOvc<< o N Sy s:~rh (Initial) Wastewater Flow: 3~b GPD
(See note below, if applicable
4-"/e REp~<,,\0 4 3- 5<EK, (Repair)
Installation Requirements/Conditions Number of trenches 1+
Septic Tank Size tUod gallons Exact length of each trench feet Trench Spacing: c1 Feet on Center
Pump Tank Size gallons Trenches shall be installed on contour at a Soil Cover inches
Maximum Trench Depth of: M inches (Maximum soil cover shall not exceed
(Trench bottoms shall be level to +1-114" 36" above the trench bottom)
in all directions)
Pump Requirements: h. TDH vs. GPM inches below pipe
Aggregate Depth: inches above pipe
Conditions: Lr ~s C, M vs < ~E 10l C=n.p SAPS T L Syr~,~ inches total
V-r%>✓ '"%C- C'1P~ r.e Qe'~Ll1 a,f N1 lo.~ an ( 4a~Cl Cf~
**If applicable: / understand the system type specified is different Mom the type rpecired on the app/ication. / accept the rpeci&dtionr o/ this permit.
Owner/legal Representative Signature: Date:
This Construction Authorization is Stlb. t vocation if the site plan, 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 subject to com eitt ions of the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent: V1pA a Ly--,06 R~Date: ~1 l0
nstruction Authorization Expiration Date: G t-T li"
HTE# lC~ r -a` a~O~o Permit # a.C ~3 y
Harnett ('onnty I)epall,"ellt of 1'iiblic Health
Site Sketch
PROPERTY LOCATON: 1 ocvpEtzc~S R
ISSUED TO: Q EG -c N SUBDIVISION ~+C~EcZGE/L LOT # `-l
Authorized State Agent: ~aL►SJO/t~ Date: C, )-7Ito
3 `1 r1' t
4S5
Pd No11Z O-> P, Q.o
Department of Emironmenk Health and Natural Resources
Division of Environmental Health
On-Site Wastewater Section
SOILSIT>c EVALUATION
for ON-SITE WASTEWATER SYSTEM
Sheet:
Property ID:
Lot
File
Code:
Owner. Applicant:
Address: Date Evaluated: r,) n
PTOposed faeilitT "3 tcdr~ Desip Flow (.1949): ,(XjP~ Property Size:
Location of Site: propedj Recorded:
Waters Supply 0C ❑ Individual ❑ Well ❑ Spring ❑ Other
Evahhaton Method:
7ger Boring ❑ Pit Cut
'9
Type of Wastewater. 'R Sewage ❑ Industrial Process Mixed
P
R
O
F
SOIL MORPHOLOOY
OTHER
1
.1940
1941
PRUFILS FACT ORS
L
Lana"
Horizon
.1942
E
M
Poeitiow
Slope %
Depth
(110
.1941
►
Sb
d
.1941
Sod
.1943 .1956 .1944
Rof1N
u
un
Texture
Conwda m
Minulb
Wet"
Colo
Soil Seprv Re*
D
C!"
r
etA
IN. Cler Hats
-
A LTAX
S
'V F-yk
S;
LG
C 5 V F2 w3
P5, L-
Met Factors (.1946X
Sits ClaWcatlon (.1948k 5
Evahrated By. O
Others Present: 0 K,