IPAC RHTE# /9- ~ zyl,/ iZ Harnett County Department of Public Health 2 6 0 6 2
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: J2
ISSUED T • .l y U klZ~T 14 SUBDIVISION LOT #
NEW 0 REPAIR ❑ EXPANSION ❑ Si (e Improvements required prior to Construction Authorization Issuance:
Type of Structure: -5 F t? _
Proposed Wastewater System Type: 2s'4lo fl~~Ayc-
Projected Daily Flow: 3 L 0 GPD
Number of bedrooms: 3 Number of Occupants: Pa max
Basement ❑Yes 2 ~
Pump Required: ❑Yes ❑ No 0-May I e required based on final location and elevations of facilities
Type of Water Supply: ❑ Community E2' Public ❑ Well Distance from well feet Permit valid for: 6 --five years
Permit conditions: 0 Z2~ .4-1>%~,)~lr s 49L- ❑ No expiration
Authorized State Agoc.___ 4' "2 _ ~4L.~_IZIZ214L Date: -7 SEE ATTACHED SITE SKETCH
The issuance of this permit by ealth 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 layout.
ISSUED TO: PROPERTY LOCATION: Z ' :5--6& 4:a',
SUBDIVISION / LOT #
Facility Type: S /New Expansion Repair
Basement? ❑ Yes No Basement Fixtures? ❑ Yes INO
Type of Wastewater System" 4~~ A--b VZ121 13 ~f-cc -me=4 f<A (Initial) Wastewater Flow: 3 L O GPD
(See note below, if applicable
/ tt 07) 2S~/~ ~~t3 (Repair)
Installation Requirements/Conditions Number of trenches 3
Septic Tank Size / 000 gallons Exact length of each trench / OCR feet
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of. Z$ inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
Pump Requirements: ft. TDH vs. GPM
Trench Spacing: 07 Feet on Center
Soil Cover: e/ inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
inches below pipe
Aggregate Depth: Z inches above pipe
Conditions: .~~fdyJe- 17- inches total
**If applicable: /understand the system type specified is different from the ty pe specified on the app&.7tion. / accept the specifications of this permit.
Owner/Legal Representative Signature: Date:
This Construction 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
Authorized State Ag Date: 7 -/G -/0
Construction Authorization Expiration Date: -7 -/6-/67
HTE # /b - 5-- Z y7 G l Permit # b D (p 2
Harnett County Depailment of 1- ~ blic Health
bite S'
ketch
PROPERTY LOCATON: Z az 44{,e IM
ISSUED TO: D b"3 b Z!lliR SUBDIVISION L4k, /lkl LOT # j,"_
Authorized State Agen Z Date: 7 -
/v 177- /
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Department of Environment. Health and Natural Resources
Division of Environmental Health
On-Site Wastewater Section
SOaJS1TE EVALUATION
for ON-SITZ WASTMATER SYSTEM
Owner Applicant: Zy?ti
Address: uatet-
PmpoW Facility:54- Desip Mow(.19 9Y Y-0
Location of Sites Pro" Recorded:
Water Supw. Pablo ❑ Individual ❑
Evaluation Mt:lhad: Auger Boring ❑ Pit
Type of Wastmier Sewage ❑ hdllstrial Process
Sheet:
Property ID:
Lot N:
File a:
Code:
Property Size:
Well ❑ Spring ❑ Other
Cut
Mixed
P
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1940
OIL 4(OIIPHOLOOY
.1941
THER
PROFILE FAL"tOR~
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.1941
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1941
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Wa4reaa!
Color
.043 .1936
soil 3"M
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.1944
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