IPACHTE# ~0- zI/ C Y 6 Harnett County Department of Public Health 26171
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATIO 7 Xd.
ISSUED TO:
SUBDIVISION
& ~za J- ',f LOT # 9r
NEW (
_
1
REPAIR ❑
EXPANSION ❑
Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: LJ-FD L/ V
JJ
Proposed Wastewater S
ystem Type: )J'- t
Projected Daily Flow:
GPD
Number of bedrooms:
13
Number of Occupants:
~ max
Basement ❑Yes
F~?Co
Pump Required: ❑Yes
❑ No
hid'Ma a required based on final location and elevations of facilities
Type of Water Supply:
❑ Community
Public ❑ Well
Distance from well feet Permit valid for. F7 Five years
Permit conditions:
❑ No ex
iration
p
Authorized State Agent:: ` w ~l f Date: `y l/ 11,20 10 SEE ATTACHED SITE SKETCH
The issuance of this permit 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 out
ISSUED TO: LZ r 111'1.~r PROPERTY LOCATI N: 7~, ~ Id.
SUBDIVISION o. ! LOT #S`
Facility Type: ~ New ❑ Expansion ❑ Repair
Basement? ❑ Yes ET No Basement Fixtures? ❑ Yes ❑ N
Type of Wastewater System** ai-7, Co_
(Initial) Wastewater Flow: GPD
(See note below, if applicable
,2 -r-7. (Repair)
Installation Requirements/Conditions Number of trenches
Septic Tank Size CgC3 gallons Exact length of each trench o~ U feet Trench Spacing: Feet on Center
Pump Tank Size gallons Trenches shall be installed on contour at a Soil Cover. Z inches
Maximum Trench Depth of Q3 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
Aggregate Depth: inches above pipe
Conditions: o .v rc~f inches total
ft~l ~~ca ~C> 1 r c~ .iwl e~4- j mot,! /(3 _ ell y ~J .r"y 1Fc
*If applicable: / understand the .ryrtem type rpeciled it different from the type rpeciled on the app/ication, l accept the SO eci
lcationr of this permit
Owner/Legal Representative Signature: Date:
This rnnctrurtinn durhn~on~n i, anhfe.r r„ a .h.. ..i..- _i_.
r• r ° , " ,nane- oiuuuwun numumauun man not oe transterrea wnen mere is a change in ownership of the site. This
construcnon nutnontation 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 Agent- Date: °2 /0
Construction Authorization Expiration Date: J "Z 0 /-f-
HTE# Permit # a
narnett ("ountyT Department of Fi blic nealth
Site Sketch
PROPERTY LOCATON: a
ISSUED TO: SUBDIVISION LOT #
Authorized State Agent: ~f Date:
I
~ f
~ r
I
Department of Environment, Health and Natural Resources Sheet:
Division of Environmental Huth Property ID:
On-Site Wastewater Section Lot M:
SOR1SM EVALUATION File M:
for ON-SITZ WASTZWAT>LR SYSTEM Code:
Owner. Applicant: 6
Address Date Bvaluated. V
Prqmed
L o(~ty- De gn Flow (.1949): Prop" Size.
water $nppljr' rAuger l#c p~h Recorded:
[I Individual Well Spring Other
Evaluation Method; Boring Pit cut
Type o(Wa~tawater: wage ❑ Industrial process Mixed
P
R
O
P
Son, MORPHOLOOY
OTHER
1
L
.1940
L
d
H
1941
PROFIL,RPACtOR
3
E
4
acapo
a~
Poeidod
Slops'
orizon
Depth
(110
.1941 .1941
Struotun► ConsIdem
1941
Son
watnnaf
.100
.1956
.1944
RW%
Texture Mimnb
Colas
soil
IN
SBpre
Cler
Re*
Hans.
Clam
A L?A%
Site ClaWcadon (.194ik 1'-'
Evaluated By
Others Present: