IPACHTE# /C - y L Harnett County Department of Public Health 2 61 8 0
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATI
ISSUED TO: ~G.-~ SUBDIVISION cr~~J
NEW P" REPAIR El f EXPANSION El LOT #t ~ G 7
Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: 5-E11:~ 7
Proposed Wastewater System Type: fa ~e ~ -4:'N
Projected Daily Flow: ' Q GPD
Number of bedrooms: 3 Number of Occupants: max
Basement ❑Yes 2"No
Pump Required: ❑Yes ❑ No 2 /Ma be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community Public ❑ Well Distance from well feet
Permit valid for. ~e years
Permit conditions:
❑ No expiration
Authorized State Agent:: Date: SEE ATTACHED SITE SKETCH
The issuance of this permit by t ealth Department in no arantees the issuance of other permin. The pe brmit hold' is respnsible (or checking with approprate overning bodies m meetng their requirementz. This
, plat or the intended use cha nges . The Improvement Permit shall not e affected by a c ohange in ownership of'
stheite is Laws subjandect R to Rules for revocation sewage e the siCe Treatmeplntanand Disposal a n of to conditions of this permit.
f the site. This permitg is subject to compliance with the provisions of
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 T0: PROPERTY LOCATON:
SUBDIVISION J" LOT #
Facility Type:` erlew ❑ Expansion ❑ Repair
Basement? ❑ Yes No Basement Fixtures? El Yes 11 No
Type of Wastewater System** (Initial) Wastewater Flow: 76 c
(See note below, if applicable GPD
(Repair)
Installation Requirements/Conditions Number of trenches
Septic Tank Size Z00 Q gallons Exact length of each trench _2J--
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. -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. TDN vs. GPM
inches below pipe
regate Depth: inches above pipe
Conditi ns: v~ ii~ctr-... C,rl.4_k~=,~ do u, el-` o.It~u., A~S
If applicable: / underftand the ryrtem type rpeci6ed it different from the type .rpecilled on the app/icatioa. / accept the .rpeci>icationr 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
v,
Authorized State Age Date: bZ0,/ c _
Construction Authorization Expiration Date:
HTE# Permit #
Harnett County Department of I'tlblic Health
Site Sketch
PROPERTY LO(ATON:
ISSUED TO: SUBDIVISION LOT # !
Authorized State Agen Date: 7 0
tY~
G-16Uc t,, C4_
Dgmtrnent of Emimninmt, Health and Nature! Resource Sheet:
Division of Environmental Health
t
On-Site Wastewater section LoProperty ID:
Lot N:
SOiQ,/ M 19YALUATION File
for ON-S Code:
lag WAS'i'M&I sit SYSTEiVfE
Owner. Applies
Addrem Date Bvaluata.7/-Z? e,
Proposed Facility: DeMp Flow (.1949r Pmp" Size:
Location o[ SItc Property A worded:
Water Sup*_ (pt" i~c ❑ Individual C] Well C1 Spring
Evaluation Method: a Boring ❑ Pit cut
Type of Wastewater; Sewage ❑ industrial Process Mixed
P
R
O
F SOIL Mo"MLOOY ~
t .1
Laxb" 940 1941 PROFILE FACT(
L Horitoa
9 Po~itlad y .1941 4
.1941 .1941 Sod 1 X43
tl slope '1~ (laj StraoMr+d Condda" web," 3oi1
Texfin Minm1o Color IN.
1-f 7 10-
~i
51~3 I G-/-r
(0-
❑ Other
196 .1944 Pbft
3~prv Re* CGM
Cllr Haft. A LIAR
fad
f-~
site Cimino tlm (.194 ; ~f
Evahmied By-
< - Others pre=*