IPACHTE# lQ-S'a ASfi \N Harnett County Department of Public Health 26146
Improvement Permit
A building permit cannot be issued with only a Improvement Permit
PROPERTY LOCATION: Ve) !,p ~JS p, Qsj
ISSUED T0: ~m6~.~cvcvfl `~OmLg 1N(, SUBDIVISION C.nciotl up, SC~.SOsvS LOT # 5}
NEW ZI REPAIR Q EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: SGQ C
Proposed Wastewater System T pe: err r~ v, ~dN p~.
Projected Daily Flow: GPD
Number of bedrooms: 3 Number of Occupants: max
Basement ❑Yes ] No
Pump Required: ❑Yes ❑ No 'X May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community _~K Public ❑ Well Distance from well NO b feet
Permit conditions: Permit valid for. Five years
❑ No expiration
Authorized State Agent: Date: `1 s l SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the issuance other permits. The permit holder is res onsible for checking with appropriate is subject to revocation if the site governing bodies in meeting their requirements. This
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: CQ r,ar ~p,Np ~A o cc%G~b l,4 t; PROPERTY LOCATION: YO "10E1> oS A"
SUBDIVISION ~AC2DL~ryJa ~`~ONS LOT# 5
Facility Type: New ❑ Expansion ❑ Repair
Basement? ❑ Yes "_Is< No Basement Fixtures? ❑ Yes ~No
Type of Wastewater System' C16 r4IJ (Initial) Wastewater flow: 340 GPD
(See note below, if applicable
C:0" osgr,,,L (Repair)
Installation Requirements/Conditions Number of trenches }
Septic Tank Size 1, b o v gallons Exact length of each trench 1S`o feet Trench Spacing:
Feet on Center
Pump Tank Size gallons Trenches shall be installed on contour at a Soil Cover: 13='u
inches
Maximum Trench Depth of: a4 - 3O 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
V% Aggregate Depth: inches above I e
Conditions: ~L N G Ctl,>-yT ~ l0' P P
Q-, MN-i
'0 P" C, rr G~ys;~"` 1a inches total
r - t' ~If applicable: l understand the system type specified is different from the type Oecillied on the application. / accept the s0 Cl-ations o/thi permit.
Owner/Legal Representative Signature: Date:
This Construction Authorization is subject to revocation i sit n, plat, or the intended use changes. The Construction Authorization shall not be transferred when there is a change in ownership o[ the site. This
Construction Authorization. is sub! ct compliance wit e e Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent: t-C~S Date: _ 7 1
Cons ction Authorization Expiration Date:
HTE# Permit # M 41
nett Coliiit.1 I)ep-11 ,11KIlit of I'llblic Fie( lth
site sketch
PROPERTY LOCATON: PON~S~.
ISSUED TO: Cio n, cb p cime5 l ti SUBDIVISION Gc P, SEPiSO NS
LOT # 5 )
Authorized State Agent: ~pL~ d~0o
Date: _ 1) 10
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Deparhnent of euvimnmenk Health and Natural Resources
Division of P°WrounenW Health Sheet:
On-Site Wastewater Section Property ID:
Lot l!:
s0nisru EVALUATION File
for ON-SITIL WASTIWATICR SVSTXM Code:
Owner t+~ Applicant
dd
Date Evaluat
Proposed Facilih',) ~ ed:
Cj)Cr. ` DeMpfgow (.1949y-2 6
Location of site; ~e Property Size:
Water Suppt~; tseroper~► Recorded:
Evaluaion Method; IndiviD Well ❑ Spring ❑ Other
Type of Wasbevvater: °Ser Boring ~
wage ❑ tndustl al Process mixed
P
R
O
P 30IL NORBHOLOOY
1
L Lath= .1940 .1941 OTHER
E Pop Horizon PROM" FACTORS
1941
91 ~ O0{ .1941 .1941 gfA -
t
° ~ savat" Coluldma wereep/
Tendo
.1743 .1936 .1944 ft &
9oi1
n Mianb Color
39° Raab CAN
IN, Ctur H
il
A L
a
s.
T,q>A
VF2 5
S V R
r+6
l
S .2?
r s
- Vraer rectors (.1946) 4
Site Classillcaaon (,1948)-5
^J -w r• Evehated By: C~
Others P vmt 8 47