IPACHTE#~o - 5 - zy7:,~7 Harnett County Department of Public Health 2 6 0 5 9
Improvement Permit
A building permit cannot be issued with only an improvement Permit
PROPERTY LOCATION- i~Ti✓S /Z16
ISSUED T SUBDIVISION Sr,:~- i,T LOT # /I
NEW REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: SF b
Proposed Wastewater System T pe:,~,~af~~ ~v ~~iZfnd
Projected Daily Flow: 3~ GPD
Number of bedrooms: Number of Occupants: L max
Basement ❑Yes L~J No
Pump Required: Zies ❑ No ❑ M be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community Public ❑ Well Distance from well feet Permit valid for 12 Five years
Permit conditions: ❑ No expiration
Authorized State Ag 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 taws 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, .1951, .1958. and .1959 are incorporated by references
into this permit and shall be met. Systems shall be installed in accordance
ISSUED TO:
PROPERTY LOCATION:
Facility Type:
SUBDIVISION Fsk3
2 New ~ Expansion ❑ Repair
LOT # _ 11
Basement? ❑ Yes No Basement fixtures? ❑ Yes 5 No
Type of Wastewater System'
,A e-5VD~ e
!701nitial) Wastewater flow: 6-0 GPD
(See note below, if applicable
via 75~~a (Repair)
Installation Requirements/Conditions
Number of trenches 3
Septic Tank Size -I/.VU 0 gallons
Exact length of each trench z~ feet
Trench Spacing: Feet on Center
Pump Tank Size /00 0 gallons
Trenches shall be installed on contour at a
Soil Cover: inches
;~/Z `~/D t~i~vGS
Maximum Trench Depth of- Z r/ inches
T
h b
h
ll b
"
(Maximum soil cover shall not exceed
"
(
renc
ottoms s
a
e level to +/-1/4
36
above the trench bottom)
in all directions)
Pump Requirements: ft. TDH vs.
GPM
lO h b I
Conditions:
Aggregate Depth:
me es a ow pipe
inches above pipe
~Z- inches total
*If applicable: l understand the system type speciled is different from the type specified on the application. /accept the specifications of thi permit.
Owner/Legal Representative Signature: Date:
This Construction Authorization is suhiert to ravnratian if rho it, n1- „6+ - k. ;-.,a.a .L.._-. TL-
I r - 1.1_.,6,,. ue uaoaeneu wnen mere is a change in ownership of the site. Ihls
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
Authorized State Agen Date:
Construction Authorization Expiration Date: 7-/-5-/5
HTE # ~Q - S = 2 `f `1 Co-7 Permit # 2 6 O fM
Harnett County Depailment of I--~lblic Health
Site 'Sketch
PROPERTY LOCATON: SC (qi?
ISSUED TO: -774C SUBDIVISION n~77-/-3~ LOT #
Authorized State Ag t: ` Date: 7-1 !b
4 bb N0- PL) Dv~ L,(-- ~ e--s ut3de~f-
3-I/z-1(---,4-q0 V+lves
n~
Pl ooN Cm ~1 12-,
Department of Envimmnenk Health and Natural Resources
Division of Environmental Health
On-Site Wastewater Section
S01USUZ ZVALUATION
for ON-SITZ WASTZWATZB SYSTEM
Sheet:
Property ID:
Lot N:
File M:
Code:
Owner. Applicant: 21741
Address Date Evaluated: -7-1z.40
Proposed Location a~aS lty: ~ DCAP MOW (.1949y 3~O Property Size: , 5 a
Property Recorded:
want snpp[r. []~Pubuc ❑ mVidual ❑ Well C1 Spring C1 Other
Evaluation Method: C3'~nges Boring ❑ Pit cut Type of Wastaorater: [ Sewage ❑ Industrial Pmcess Nxed
P
R
O
P
SOIL NORPHOLOOY
OTHER
I
.1940
.1941
PttOFtLa FACTORS
L
Landuap
Hurhm
.1941
B
Posidod
D%A
.1941 .1941
Sol
.100
1956
194+
AVOID
M
Slop
(ia)
Souc u W Coaddaea
Webmw
soil
.
Sap'o
.
Real`
Clew
Taal Mtwnlo
Color
1N.
Clue
Haft.
A LTAR
5 -2o
Gn -
20-KS
6'G.t_ I'"
Y~~ GS4G
~D 0 -1 C ~
"j6 16 -1
1 '1.,
*Other Y Factors (.1946)
Site ClassiHcadou (.1948X
Evahuated By
Othas Premt
y