IPACHTE# Harnett County Department of Public Health 2 61 3 8
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: Qq
ISSUED T0: ~ ~I L SUBDIVISION s NG 1 P ~P, C-C LOT # I-Q,
NEWX REPAIR E( EXMION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: `J bi
Proposed Wastewater System Type: PQ ^ \P C"o'4 y Ertl s o tJ P%
Projected Daily Flow: 3 ~D GPD
Number of bedrooms: 3 Number of Occupants: max
Basement ❑Yes XNo
Pump Required: ❑Yes ❑ No ay be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community Public ❑ Well Distance from well 100 feet
Permit conditions:
Permit valid for: ve years
❑ No expiration
Authorized State Agent:: \L~5 Date: (n, Ida SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the issua 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, .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 TO: AQ ~ c-~vNG Va C- PROPERTY LOCATION: Ny£N V-D
SUBDIVISION \ \ G, E.N 1-a,c-6 LOT # -LA-4,_
Facility Type: 5 K) New ❑ Expansion ❑ Repair
Basement? ❑ Yes I<No Basement Fixtures? ❑ Yes XNo
Type of Wastewater System** y "-~-P C.o N v c "r-, v0 tv P, L-- (Initial) Wastewater Flow GPD
(See note below, if applicable
pv M -p
Installation Reuuirements/Conditions
Septic Tank Size \ 000 gallons
Pump Tank Size t O0 O gallons
C-0 N vC-► o ty pc 1~. (Repair)
Number of trenches a
Exact length of each trench 71 S feet
Trenches shall be installed on contour at a
Maximum Trench Depth of: a~ 3~- inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
Trench Spacing: 1 Feet on Center
Soil Cover: inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
rump nequfrements: tt. I urt vs. GPM 'IC, inches below pipe
Aggregate Depth: a, inches above pipe
Conditions: ~A~E~~ v~re ~vs~ ~E ~O ~ZO,-~ SE~vGCJyST~,,~ d \zi" inches total
V -T\ 4- A`/ E..s GC2 a A l l.\ d N \ 1 A(_ tl2 ~p P~ l(Z ~S~M
**If applicable: / understand the system type specified is different from the type specified on the application. l accept the specifications of thi permit.
Owner/Legal Representative Signature: Date:
This Construction Authorization is subject to revo if the Ian, 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 to complia ith t he Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent:
NS Date:
NO
Authorization Expiration Date: 6
NTE# 10 s~ ~Ll ~3~ Permit # r" 13%
Harnett County I)epartment of IlUbli c Health
Site S v ketch
PROPERTY LOCATON: N C, E,.c
ISSUED TO: \Q N _2cg, ~G SUBDIVISION r"6E.,, 'P L.rc-C -LOT #
Authorized State Agent:
`S"oly S,°f ate: S I l
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Department of Envimanment, Health and Natural Resoums Sheet:
Division of Environmental Health Property ID:
On-Site Wastewater Section Lot:
SOIUSITE EVALUATION File N:
Code:
for ON-81 TB WA3'PMATIEH SYSTZM
Owner. Applicant
Address Data Evaluated: C~a 3
Proposed FWWt Design Flow (.1949): 401~
Property Size:
Location of Site: Property Recorded:
Watts Supptyr Public ❑ Individual ❑ Well
❑ Spring ❑ Other
Evaluation Method: Auger Boring ❑ Pit
Type of Wastewater: S
❑ I
.
Cut
ewage
ndustrial Process
Mud
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OTHER
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Horizon
1942
9
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.1941
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.1941
.
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143 .1956 .1941
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