IPACHTE# s = zrZ- ~ Harnett County Department of Public Health 2 f 0 5 7
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
Z PROPERTY LOCATION: 5, y/z_{
ISSUED TO ,r-
suBDlvlsloN LOT # z'_
NEW 0 REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: 5 FI)
Proposed Wastewater System Type:
Projected Daily Flow: GPD
Number of bedrooms: Number of Occupants: max
Basement ❑Yes 0 No
Pump Required: 6es El No ❑ M be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community Public ❑ Well Distance from well feet
Permit conditions:
Permit valid for. 12' Five years
❑ No expiration
Authorized State Agent.
Date: SEE ATTACHED SITE SKETCH
The issuance of this permit 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, with the attached system layout .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
ISSUED T0:
PROPERTY LOCATION
I
Facility Type:
SUBDIVISION
S ✓~z~~ LOT # 12
Basement? 11 Yes No
L1 New El Expansion ❑
Basement Fixtures? ❑ Yes C?-/No
Repair
Type of Wastewater System-
7'~
I
i
i
l
W
(See note below, if applicable
(
n
t
)
a
astewater Flow: GPD
7414-lklr'~
Installation Requirements/Conditions
'An
4liepair)
Number of trench/es .fi
Septic Tank Size ! vyo
Pump Tank Size
gallons
ll
Exact length of each trench o°y
feet Trench Spacing:
Feet on tenter
J 0 C'7 d
ga
ons
Trenches shall be installed on contour at a
Soil Cover: 4 inches
Maximum Trench Depth of. Z y "
inches (Maximum soil cover shall not exceed
(Trench bottoms shall be level to +/-1/4"
II d'
36" above the trench bottom)
Irecuons)
Pump Requirements: In a ft. TDH vs. GPM
Conditions:
G inches below pipe
Aggregate Depth: z inches above pipe
Z-- inches total
**If applicable: /under Land the system type specified is different from the type specified on the app/ication. /accept the rpecificatioar of thin permit.
Owner/Legal Representative Signature:
This Construction Authorization is subject to revocation if the site plan, plat, or the intended use changes. The
Construction Authonzation is subject to compliance with the
Authorized State
Date:
Authorization shall not be transferred when there is a change m ownership of the site. This
of the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit. SEE ATTACHED SITE SKETCH
Date: Z-T"w
Construction Authorization Expiration Date: 7-r -~S
HTE# ZZ -S--ZzIZ 5-8 Permit # Z11 ~ S 7
Harnett (county Department of Miblic Health
Site Sketch
PROPERTY LOUITON:/y~z
ISSUED TO: SUBDIVISION LOT #
Authorized State Agent ~~~y
v V Date: 7- ~ - s v
r
A
Department of EwAmnnmt, Health and Natural Resourm Sheet:
Division of Environmental Health
On-Site Wastewater Section Property ID:
Lot M:
SOE[JSPPZ ZVALUATION File M:
for ON. "Tw WA9 Code:
TEVT JI & f SY9Tli m
Owner. Applicant
Addrem Date Evallited: D
Proposed Faoillh"• Desip Flaw (.1949r Property Size:
Locatiou of Site: Propel iteoorded:
want Snpplj Q-fubik ❑ Individual ❑ Well C1 Spring ❑ other
EvaluaRton Method: uger Boring 0 Pit Cut
Type of Wastewater: Sewage ❑ Industrial Process Aced
R
O
F
I
E
M
900, MORPHOLOOY
LXW
.1940 L
Apr Horizon .1941
oid % tl~ .1941 .1941
ctr l Con d@M
7
18 _3y x~,
L 2 o - ZY sL,
2`~-YD k
OTHER
PROMA FACTORS
.194'3
s0R 1956
Wd new
~N3~Sttri~' 3j,"7 y~
J>n
.1944 ftwft
Raab CIM
Harts. ALTAR
Otha Factory a 15.m c '
site CIMMatim (.1948)
Eveiwtad By:
Others Pmm*