IPACHTE# i~ ~qeci Harnett County Department of Public Health 2617
s
Improvement Permit
A building permit cannot be issued with only an lpt provement Permit
ISSUED T0: PROPERTY LOCATION: ~T u c fc s
Y SUBDIVISIONc It V rl
NEW [0' REPAIR ❑ r EXPANSION 171 LOT # tI,.3
Type of Structure: 5"IrO S-0 K S Site Improvements required prior to Construction Authorization issuance:
Proposed Wastewater System Type-Yhc~""~ - a-- ~ ~5 Ji-,
Projected Daily flow: CSCG GPD
Number of bedrooms: Number of Occupants: L max
Basement ❑Yes 2-10
Pump Required: ❑Yes ❑ No P?May a required based on final location and elevations of facilities
Type of Water Supply: ❑ Community Public ❑ Well Distance from well
Permit conditions: feet Permit valid for. e years
❑ No expiration
Authorized State Agent: Datr °7 2 Z 2eic~
TSEE he issuance of this permit by the Health Department in no way guarantees the issuance of ofher permits. The permit holder is responsible for checking with appropriate governing bodieA[n m
ATTACH SITE egETements. 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 subj ect 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, .1952, .1954, .1955, .1956, .1951, .1958. and .1959 are incorporated by references into this permit and shall be
with the attached system layout met. Systems shall be installed in accordance
ISSUED T0: % y c~ PROPERTY LOCATION:
SUBDIVISION ~yc ~y,cT' L Sto-yl LOT #
Facility Type: ~ew ❑ Expansion ❑ Repair
Basement? ❑ Yes El"No Basement Fixtures? ❑ Yes ❑ No
Type of Wastewater System*~~~4,~
(See note below, if applicable ❑ / (Initial) Wastewater Flow: GPD
w
Installation Requirements/Conditions Number of trenches
Septic Tank Size ow gallons Exact length of each trench
Pump Tank Size gallons feet Trench Spacing: ~ Feet on Center
g Trenches shall be installed on contour at a Soil Cover. -r inches
Maximum Trench Depth of. _ 1,2- 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
Conditions: k"' d,VN"- 1c
le-
~r`~~l ~ti.r{ w.ll dtC~ Iuecj r CQtt~~ S ~t
-If applicable- / understand the syrtem type specihed is different from the type specified on the app/ication. 153
inches below pipe
grete Depth: inches above pipe
inches total
cept the specifications of this permit.
Owner/legal Representative Signature:
Date:
This Construction Authorization is subject to revocation if the site plan, p(at or the intended use changes. Fhe Construction Authorizat on 'hall uolb, ansferredwhen there is a change in ownershp of he itThis
CstructiAthoriztin is ubject o ompliahpons of the Las and Rules for Sewage and Disposal nto he cof this permit SEE ATTACNED SITE SKETCH
Authorized State Agen ~2csf G
Date: 7 /Z'~-
Construction Authorization Expiration Date:
HTE# Permit # 0~ 1 7 ~
Harnett county Department of Public Health
ite ketch
ISSUED T0: _ c~ V
Authorized State Agent:
4'~ dyd /1,
Department of Euvlronmenk Health and Natural Resources Sheet:
Division of Environmental Health
On-Site Wastewater Section Property ID:
Lot H:
SORJSM 9VALUATION File M:
for ON-RI[Ta mu Code:
A9TAVVATEIEE 9Y3TLn
Owner. Applicant
Address Date 6vahwtod: o
Proposed Facility: DesigO Flow (.1949}: Pmpeny Size:
Location of Site: propert~r Recorded:
Watu SnppEj 11C ❑ Individual ❑ Well
Evaluation Meth gar Boring El Pit cut C3 Spring
Type of Wastewater Sewage ❑ Industrial Process Mixon
P
R
O
P SOIL NORPHOLOOY
t .1940 .1941 PRo IiEA
fr~ u PAOT(
p Heeisw .1941
R PosideW DqA .1941 .1941 Son
M Sfop~ 7t, (1aj Sbuen" C01Wd M 1146
Texk n Nf mlo
C
1,
lifItIl
f1o
webs" 9oi1
1°YI711 2:)"
/Oy~f V/ 21"
❑ Other
1936
.1944 Prof
Re* CIM
f
ALT
,2
Mar Factors (.1446) '
Site Clasai&adon (,1948)
Bvalrmted
Others Present!