IPACHTE# 10- 5%1 -1 Harnett County Department of Public Health
Improvement Permit 2 6 2 2 4
A building permit cannot be issued with only an I~provement Permit
` PROPERTY LOCATION: kJOHo~ao~,p~ Rp
ISSUED TO: C v rn C r=a'-P ~ AZ) M 1 N C- SUBDIVISION C RQ0 La N i~' LOT # _
NEW REPAIR P EX NSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: _FO `tea
Proposed Wastewater System Type: 7. RE,nw% 10,,, ~ M
Projected Daily Flow: 3C-0 GPD
Number of bedrooms: '3 Number of Occupants: max
Basement ❑Yes -'~K No
Pump Required: ❑Yes ❑ No ~ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community ~K Public ❑ Well Distance from well COO feet Permit valid for. Five years
Permit conditions:
❑ No expiration
Authorized State Agent.: :A~~ ~ Date: 8 ~ Id SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guaran§th nce of other permits. The permit holder i 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, .1951, .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: ~bNS7~2oS~.
SUBDIVISION Cc~-ni-<<-x e
Facility Type: SEA~U a 5 LOT # 83
New ❑ Expansion ❑ Repair
Basement? ❑ Yes I„ No Basement Fixtures? ❑ esNo
Type of Wastewater System' RED LT C~ t ~ h Sys-,-c- n (Initial) Wastewater flow: ;~C 0 GPD
(See note below, if applicable /
45 6/o R> o te~„J (Repair)
Installation Requirements/Conditions Number of trenches 2
Septic Tank Size t o o (1) gallons Exact length of each trench a feet Trench Spacing: Feet on Center
Pump Tank Size gallons Trenches shall be installed on contour at a Soil Cover Q inches
Maximum Trench Depth of. inches (Maximum soil cover shall not exceed
(Trench bottoms shall be level to +1-114" 36" above the trench bottom)
in all directions)
Pump Requirements: ft. TDH vs. _ GPM
Conditions:
inches below pipe
Aggregate Depth: inches above pipe
inches total
WATER LINES (INCLUDING IRRIGATION) MUST BE ]OFT. FROM ANY PART OF SEPTIC SYSTEM OR REPAIR AREA.
NO UTILITIES ALLOWED IN INITIAL OR REPAIR DRAIN FIELD AREA.
""If applicable: / understand the system type .rpeciled is different from the type speciled on the app/ication. / accept the tpec16cationr of this permit.
Owner/Legal Representative Signature: Date:
This Construaion Authorization is s revocation if the site plan, plat, ~tl, dd use ha nge. The on Auftat,,on alnoasferrd whn tha change in ownership of the site. This
onstruoAuthatn is subject to coof thules for Sewage Treatment and Dispose conditons of thupermit SEE ATTACHED SITE SKETCH
Authorized State Agent: f15 Date: 3 l
truction Authorization Expiration Date: 6
HTE# L Q- 5- '1 Permit # _ ab~L}
Hill"sett ConntY Department of Pub] is Health
Site'S11etch
PROPERTY LOCATON:__ PoiaS~,
ISSUED TO: Cu WN e, ,J nrn 1 N C. SUBDIVISION Cr+~to~ w a ~at"t5 LOT # g3
Authorized State Agent: Cotes i o~~cZ~ Date: ~l 10
~s
i
G
n
-i5."
Department of Environment, Health and Natural Resom,,
Division of En ironmeutai Health
Sheet:
On-Site Wastewater Section
Property ID:
Lot
SOIUSM EVALUATION
File lw:
for ON-SITZ WASTEWAT168 $YSTE Vt
Code:
Owner: Applicant:
Addrem Date Evahlaled:
Proposed Facility: Design MOW (.1949Y.
Locadon of Site
Ptvpertp size-
Pro0e10 Recorded:
watts Supptj ❑ Public ❑ Individual ❑ Well Evah"don Method: ❑ Auger Boring ❑ Pi
❑ Spring
❑ other
t
Type of Wastewater: ❑ Sewage ❑ Industrial Process
cut
Mlxea
r
a
O
P
1 .1940
901, MORPHOLOGY
OTHER
L A
po
.1941
Harizm
PROFU FACTORS
posid
A 91 "oa
%
.1942
DqA .1941 .1941 Sod 00 S CUVW Cort>rtme webwof
$43
_
.1916 .1944 Pbtb
Teadn Mhwwo Color
S IIV
~ H * CIM
0
,5)5o i0 JCL IJO~
NA t4e
'30 I `-1
NP
Mar Fsctara (.1446k
Site Classification (.1948) a
Eulualed By:
Othcs Preserit