IPACHTE# /d Harnett County Department of Public Health 26167
Improvement Permit
A building permit cannot be issued with only an Improvement Pe it
PROPERTY LOCATION: a- ke,r 11?d-
ISSUED TO, ~GAJ-r, 1.3 SUBDIVISION C
NEW e REPAIR I--] EXPANSION 11 sI t1e~-cn cf- LOT #
Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: ~ Q
Proposed Wastewater System Type: 4,
Projected Daily Flow: -F-k. GPD
Number of bedrooms: l1 Number of Occupants: L max
Basement ❑Ye,_~s_5810
Pump Required: LfYes ❑ No O Ma
'e required based on final location and elevations of facilities
Type of Water Supply: ❑ Community I? Public ❑ Well Distance from well feet
Permit conditions: Permit valid for. Pive years
~ ❑ No expiration
Authorized State Agent:: c.
Date: %t SEE ATTACHED SITE SKETCH
The issuance of this permit by the 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 compith the provisions of
the laws and Rules for Sewage Treatment and Disposal and to conditions of this permit. liance w
Construction Authorization
The construction and installation requirements of Rules .
with the attached system layout
(Required for Building Permit)
1950, .1952, 1954, .1955, .1956, .1957, .1958. and .1959 are incorporated by reference
s into this permit and shall be met. Systems shall be installed in accordance
ISSUED TO: k-~-)IIA C_te 7
z'ucc <ezn PROPERTY LOCATION;,4~~tC L.cs kkf
Facility Type: J_~c J
SUBDIVISION
2" N
❑ E
LOT #
ew
xpansion ❑ Repair
Basement? ❑ Yes No Basement Fixtures? ❑ Yes ❑ No
~
-
Type of Wastewater System**
~
,S
(initial) Wastewater Flow: GPD
(See note below, if applicable
z"
Installation Re
uirements/C
di
i
= 1d'" ~Q vc rt:aE. J'1 --(Repair)
q
on
t
ons
Number of trenches 3
Septic Tank Size C-0 0 gallons
Pump Tank Size l dd 0
allons
Exact length of each trench feet
T
h
h
Trench Spacing: Feet on Center
g
renc
es s
all be installed on contour at a
Soil Cover ~
.Z., inches
Maximum Trench Depth of. 9 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
Condi ions: X O v e e,/
'
inches below pipe
Aggregate Depth: inches above pipe
w , A
-s el zY
cs~ ~
c r
e l (S ~
pre
c~ inches total
,
~J ec 0,1 Cc A. j I tJ~ o / c a c
**If applicable: /understand the system type specified is different from the type specilled on the app/icvon. / accept the .rpecifIcafions of this permit.
Owner/Legal Representative Signature: Date:
This Consrruction 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
C ' ,~c ref
Authorized State Agent Date: r ,~clc
Construction Authorization Expiration Date: 2_.d"
H T E # _Zo - Y-- dV 73,2- Permit # ~ (s, ( 7
Harnett (rolint~y Dep.][1nlent of 1'llblic Health
Site Sketch
PROPERTY LOCATON: 4-F~t" o,
ISSUED TO: Cc~a.I ~rt r c SUBDIVISION e~~~~ cct LOT # lG
Authorized State Agen • Date: lff~Z~l
_it
s
Iq~
Department of Environment, Health and Natural Resources
Division of Environmental Health
Sheet:
On-Site Wastewater Section
Property ID:
Lot a:
SOMME EVALUATION
File M:
for ON-SITE WASTEWATICR SYSTM
Code:
owner. Applicant:
Addresc Date Evaluated
Proposed Facility: Design Flow (.1949):
Pmperty Size:
Locadon of Site: Fro" Recorded
Watrt sup*, ❑ PubfiC ❑ Individual ❑
Well
❑ Spring ❑ Other
Evaluation Method ❑ Auger Boring ❑ Pit
Type of Wash mater S
Cut
ewage ❑ Industrial Process
Mixed
P
R
O
F SOIL, NORM0L00Y
1
1940
OTHER
.
.1941
L LAWww Hmizm
PROMA FAORR
Poeitloel
DPA .1941 .1941
M Slope % (In) Shuemw Coadda"
,1941
Son
webmw
.1043 .1956
.1944 heft
Ted Minerelo
` c
Cola
Soft 39"
QY• Ct+ua
Ran* Cho
Hods. A L'fA1
tither Factors (.l NO-
Site ClUftatlon (.1940P.f
Evehated By: lJ
Others Pre=*