IPACHTE#. 6-S: Harnett County Department of Public Health 0 6 5
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
,f PROPERTY IOCATION:S& 1"Z) F eef,, it,/,
ISSUED : tfUs E /%,~l~yn1 r3 Y~ S SUBDIVISION J
NEW T ~ REPAIR El EXPANSION El LOT #
Li/~/>` Site Improvements required prior lo construction Authorization Issuance:
Type of Structure:
Proposed Wastewater System Type: Projected Daily Flow: 3(06 GPD
Number of bedrooms: Number of Occupants: CA max
Basement ❑Yes No
Pump Required: ❑Yes ❑ No Z(be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community ttJ Public ❑ Well Distance from well feet Permit valid for. Z /Five ears
Permit conditions: Y
❑ No expiration
Authorized State Ag Date: 9 - 3 - w SEE ATTACHED SITE SKETCH
The issuance of this permit b 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: ~~/y -e ia✓e~ ,~ics~ ,a,•u„~s-
PROPERTY LOCATION: Sr-IN-6,6
SUBDIVISION LOT #
Facility Type: New Expansion ❑ Repair
Basement? ❑ Yes No Basement fixtures? ❑ Yes AND
Type of Wastewater System" ?i&F% L'c~ vClZu~.~ysp~y_ ~,~f~Q) (Initial) Wastewater Flow: GPD
(See note below, if applicable
flLT?11 ? (Repair)
Installagon Requirements/Conditions Number trenches
Septic Tank Size fUV D gallons Exact length of each trench C~
feet Trench Spacing: Feet on Center
Pump Tank Size gallons Trenches shall be installed on contour at y r Soil Cover inches
Maximum Trench Depth of. ~ ches (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:
Aggregate Depth:
inches below pipe
7 inches above pipe
inches total
"*If applicable: / understand the system type specified is dih`erent from the type specified on the app/ication. / accept the rpecidcations of chi 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 ent: Date: f~ 3 t to
Construction Authorization Expiration Date: 3 - , s-
HTE# /6-S = 2gS6Z Permit # Z~b(. 5'
Harnett County I)eptartrnent of Public Health
Site Sketch
PROPERTY LOCATON: 5n /5-690 Ft s~5 I21)
ISSUED TO: D~ P olc,~,~iN~ VArl!;45 SUBDIVISION LOT # -2
Authorized State
R~,CQ'~
Iv'
,tot) F0 0
rl L;r-
S R I S7ao re. dv,7 )w
Department of Emironment, Health and Natural Resources
Division of Environmental Health
Sheet:
On-Site Wastewater Section
Property ID:
Lot ll:
SOtUSITZ EVALUATION
File a:
for ON-SITE WASTEWATER SVSTLNt
Code:
Owner: Applicant:
Addrem Date Evaluated: 7.36 -G~-'
Proposed Facility: 50a%44 Design Flow (.1949r 3~-D
Pmpertp Size:
Location o( Sites - Property Recorded.
Water sup* [
Public ❑ Itldividual ❑
Weil
❑ Spring ❑ Other
Evaluation Method:
Type of wastewater:
Auger Boring ❑ Pit
yA
Cut
ewage ❑ Industrial Process
Mix
ed
P
R
0
F SOULIM PHOL00Y
OTHE
1 .1940 .1941
L Lm" Horizon
P
R
ROFU FACTORS
9 Posidoul Dq* .1941 .1941
q Slope's (h) Stuaft" Comidam
.1949
SON
Web"d
Z~O43 .1976
.1944
PMM
Teadr.
Color
SIPM
clan
Re*
Hain.
clue
♦ LTA
3°,
C'-'Y
Y4-
6-4 iJ5A),a
Z L3-1M o -
to.t Nsvp
sip, 7
a -.3o
5L
lvrt iJa~l P
1 :4
V3 11,11~6i~
y L 6 .3 6 L .i. rf P
76- 1 ~ Sp, yy
Site Claui$Evahateld948By: k
Othas Pres"t