IPACHTE# -~f loo Harnett County Department of Public Health 2 61 5 8
Improvement Permit
A building permit cannot be issued with only an Improvement Per it
, PROPERTY LOCATI N: S" L /e.
ISSUED TO ~y It t ~Q K--r- -y SUBDIVISION cd a ~ ~ LOT # d"
NEW REPAIR ❑ t EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: 1 3~ z
Proposed Wastewater System Type: R S'-%v e j
Projected Daily Flow: GPD
Number of bedrooms: Number of Occupants: L max
Basement ❑Yes 01N o
Pump Required: ❑Yes k7 No ❑ Ma be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community Public ❑ Well Distance from well feet Permit valid for &-F-ive years
Permit conditions: ❑ No expiration
Authorized State Agent: - C Date: Z 2'~ 14 SEE ATTACHED SITE SKETCH
The issuance of this permit by Health Department in no way guarantees the issuance of 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, .1
with the attached system layout
952, .1954, .1955, .1956, .1951, .1958. and .1959 are incorporated by references i
nto this permit and shall be met. Systems shall be installed in accordance
ISSUED TO: ~,~Vr` A C1:1A r-tRt
t4- act PROPERTY LOCA N: cs W, f c Lam, l/ Q.
F~
Facility Type:
SUBDIVISION ci.rtic_r c~
0 New ❑ Expansion ❑ Repair
-tcs LOT
Basement? ❑ Yes Cad' No Basement Fixtures? ❑ Yes ❑ No
Type of Wastewater System**
(Initial) Wastewater Flow: GPD
(See note below, if applicable
/
~I'-~•rcQ~~fi«k~ ~SaL~r., (Repair)
Installation Requirements/Conditions
Number of trenches
Septic Tank Size (}QC) gallons
Exact length of each trench __S~O _ feet
Trench Spacing: 9 Feet on Center
Pump Tank Size gallons
Trenches shall be installed on contour at a
Soil Cover: 6
-12- inches
Maximum Trench Depth of. / 8- Z4 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
inches below pipe
-If C~ r -Q- ~1, k"
Conditions: P ' ~ a~ Co~1 u f
Aggregate Depth: inches above pipe
t `
i
All
.
inches total
f
'If applicable: / underrtand the ryrtem type fpecifed if different from the type foecired on the application. / accept the specidcmioar of this permit.
Owner/legal Representative Signature: Date:
This Construction Authorization is subject to revocation 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 compliance with the provisions of the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit. SEE ATTACHED SITE SKETCH
Authorized State Agent: ~ A ~ N..,-C Wf Date: 6 /,Z a/ c
Construction Authorization Expiration Date: .4 6 z Zc~
HTE# fc-j',Z,/CUQ, Permit # a~- t r&
Harnett Count- Depairtment of Mtblic Health
Site Sketch
J PROPERTY LOCATON: a Jwj o 6 -
ISSUED T0: ~st•• n n c un SUBDIVISION 0. Q-roa -yl r LOT #
L
Authorized State Agent: . Date: "4,0
r
(Gc
~~tti I
I IP~`J
I'D
~
C ?11%cr ~J~
Department of Environment, Health and Natural Resources Shed:
Division of Environmental Health
On-Site Wastewater Section Property ID:
Lot
SOILSITB IYALUATION File
for ON-SITE WASTEWATER 8Y9T>CM' Code:
Owner. Applicant:
Addres. Date Evaluated:
Pmposed Facility: Design Flow (.1949): Property Size
Location of Site: 17-" f(mrded
water 84w; lac ❑ Individual ❑ Well D Sprang ❑ Other
Evatu~os Mid: R Auger Boring ❑ Pit cut
Type of Wastewater: Sewage ❑ Industrial Process Mixed
P
R
O
F
RPHOt ooY
=
O
1 .1940
H
'
1941
.
THER
FtLB F AC t OR3
B Pori
on
20G
Depth
.1941
.1941
,1947
soil
1$43
A 310" %
(raj
structwd
Corwatems
wetnead
.
soil
.1916
pro
.1944
Re*
hem
CIW
Teen
iNlaaralo
Color
IN ,
_DtI
taas
Haas.
i LTA
177,
(",6
Site C1a"ificadou (.1948X J'r