IPACHTE#~°~ = aq(..7o Harnett County Department of Public Health 26162
Im rovement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION:/ A/
ISSUED T0: SUBDIVISION LOT #
NEW 0 REPAIR ❑ t EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: F d S K i6-Q
Proposed Wastewater System Type: c.1 ~ , c u
Projected Daily Flow: GPD
Number of bedrooms: 3 Number of Occupants: max
Basement [--]Yes Fe?No
Pump Required: ❑Yes L No ❑ Ma a required based on final location and elevations of facilities
Type of Water Supply: ❑ Community R Public ❑ Well Distance from well feet Permit valid for.
i~ Five years
Permit conditions:
❑ No expiration
Authorized State Agent:: C- C 2,r Z%(
Date: SEE ATTACHED SITE SKETCH
The issuance of this permit by th ealth Department in no 'Wry-guarantees 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 .195o, .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: a1v %-,if PROPERTY LOCATION:
Z New LOT #
Facility Type: I~f New ❑ Expansion ❑ Repair
Basement? ❑ Yes No Basement Fixtures? ❑ Yes,- ❑ No
Type of Wastewater System** G&ot Ue-' A-~ 4 'L (Initial) Wastewater Flow: GPD
(See note below, if applicable
C c~ 1 ~cll~:' vK"S- (Repair)
Installation Requirements/Conditions Number of trenches ,
Septic Tank Size 400 0 gallons Exact length of each trench _ feet Trench Spacing: 7 Feet on Center
Pump Tank Size gallons Trenches shall be installed on contour at a Soil Cover: inches
Maximum Trench Depth of. J? C/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: h. TDH vs. GPM inches below pipe
/ A regate Depth:_ inches above pipe
Conditions CA 1. ItQrij - c Zz inches total
ez r (e < <r cs,rrc c,J 1 ~,r : ~c~,f ~a F ~~c J / d
**If applicable: /under Land the system type specill'ed is dif[ereat tom the type specified on the app/ication. /accept the rpecifcationr of thi 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~ / , Date: S " v/ v
Construction Authorization Expiration Date:
HTE# d G Permit #
Harnett County? I)epailment of Fiblic Health
Site Sketch
PROPERTY LOCATON:_ ~nZ I ,r/
ISSUED TO: SUBDIVISION LOT #
Authorized State Agent: Date: 12-
lZ'-! d
j
r
fo dtc
Department of Em moment, Health and Natural Rem"
Division of Emrironmental Health Sheet:
On-Site Wastewater Section Property ID:
Lot N:
SOIIJSITE !EVALUATION File M:
for ON-SITE WASTEWATER SYSTEM Code:
Owner. Applicant: ~
Addram Date Evaluated: 4 ~IZIV 6
proposw
London ~ Site: ~ Desip Flbw (.1949): Property Size:
Property Recorded
Water Sup*[ ❑ FubliC ❑ Individual ICJ Well
Evaluation Method; 9Auger Boring ❑ pt Cut El Spring C1 Other
Type of Wastewater. Sewage ❑ Industrial Nxm Mixed
P
R
O
P SOIL MORPHOL00Y
1 .1940 L ~p Harizos .1941 PROMA FACTORS .1942
B Posidad Dq* .1941 .1941 S9
Slops 7V (UL)
Strnaturw ConWdauae wdnew '1y" .1916
Texture Ntaasb Color sod S.pro
Clan
r
.1944 Ftoftb
Remw Ct"
Haft. ♦LTAX
srs~
-12
F
,1p)-, f-
,6
°r Mar Factors (.1946 77
site Claaaiflcadon (.1948k~
Evaluated Byr/~
Others Premne