IPACHTE# Jo-J- a~ Harnett County Department of Public Health 2 61 7 0
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
/ PROPERTY LOCATION: c ".s a e'
ISSUED T0: SUBDIVISION _ ~
"f LOT # /l,7
NEW L?- REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: o o
Proposed Wastewater System Type: C ae,it<-s.
Projected Daily Flow: _~f i'- G GPD
Number of bedrooms: -7 Number of Occupants: max
Basement ❑Yes ~C N
Pump Required: ❑Yes ❑ No 9a required based on final location and elevations of facilities
Type of Water Supply: ❑ Community Lit Public ❑ Well Distance from well Elm
Permit conditions: feet Permit valid for ~ Frve years
❑ No expiration
Authorized State Agent::
Date: 2-~ 6
he issuance of this permit
SEE ATTACHED SITE SKETCH
T b e 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, .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 lay ut.
ISSUED TO: c~C" l~ l7`~~. e ,
PROPERTY LOCATIO "vf
~k SUBDIVISION ;J'. *4; LOT # lr3
Facility Type: New ❑ Expansion ❑ Repair
2
Basement? ❑ Yes No Basement Fixt res? ❑ Y~ ❑ No
Type of Wastewater System' C" A Jc~ 7, ~;t r 3 cu
(See note below, if applicable (Initial) Wastewater flow: GPD
(Repair)
Installation Requirements/Conditions Number of trenches
Septic Tank Size ZOO 0 gallons Exact length of each trench j 510 feet
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth oh _ ? y inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
Pump Requirements: ft. TDH vs. GPM
~v C~rL. f~, ti~- CA Cc --t v~
Cr r<g c,' Q--,, ~
r.
f7`l~ cs~
. 4 1 t/:
/ understand the system type
Trench Spacing: Feet on Center
Soil Cover: 12- inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
A re I to Depth:
1 ,ttiu( 4- l
inches below pipe
'Z inches above pipe
inches total
is different from the type speciled on the app/ration. /accept the specifications of this permit.
Uwner/Legal Representative Signature:
This Construction Authorization is subject to revocation if the site plan, plat or the intended use th
changes. The Construction Authorization shall not be transferred when there 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 per 't. SEE ATTACHED SITE SKETCH
Authorized State Agent:
L
7/ Date:
Construction Authorization Expiration Date:
I-
HTE# /a- S`- 2 /.2,Z Permit # c,,~ b t ? Q
Harnett Conn ty Department of Public Health
Site Sketch
PROPERTY LOCATON: / cre -
ISSUED
T0: l c~Fl oh < SUBDIVISION LOT #
Authorized State Agen-
Date: 7~F ol~
I
I
/t7
Y
6
~ V
~ i
f
,27 l
D J
get
6r
Department of Environment, Health and Natural Resources sheet:
Division of Environmental Health Property 1D:
On-Site Wastewater section Lot M:
SOMSU9 EVALUATION File H:
tow, ON-S Code:
11E WASTEWA I M SYSTVV1E
Owner. Applicant: k Addrem Data Evaluated: -7 l
PMPOW Facility: Design Flow (.1949): Propertlr Size:
Location of Site: Pro" Recorded:
water supptr. ik ❑ Individual ❑ well ❑ Spring
Evaluation Method: tiger Boring ❑ pit cut
Type of wastewater: sewage ❑ Industrial Process Mixed
P
R
O
F 301, NORPHOLOOY
L .19p Harizue 1941 p~
B Positlad .1944 ;
.1941 .1941 gad .143
dl elop~'lti (LLj stn c cmwdam Wdn"d soil
Ted Ntamb Color QY
& l /,~S rl ~/1,vP
U ~ G~ v IY/iYf~~ '
Site C1awi&adon (.194821'
p C/ y ✓
Evahmied LyOthers Prem* ~
❑ Other
1916
.1944 hum
RAW C1ar1
Haas. -ALTAR
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