IPACHTE# Harnett County Department of Public Health
Improvement Permit 2 6 2 2 6
A building permit cannot be issued with only an improvement Permit
PROPERTY LOCATION:_ y'ciq_ -C1<LAMg iZp
ISSUED T0: 1 S GHEL~ ~p,c~ a SUBDIVISION
NEW, REPAIR ❑ XPANSION El LOT #
Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: St` O
Proposed Wastewater System Type:~u ~T7 oCfrrv14E V t~ L
Projected Daily Flow: _ l- '$b GPD
Number of bedrooms: 4 Number of Occupants: max
Basement ❑Yes No
Pump RequirecX- Yes ❑ No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community X Public ❑ Well Distance from well E~
Permit conditions: feet Permit valid for. Five years
~ ❑ No expiration
Authorized State Agent:
Date: 4 SO SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guaran tees the iss f other permits The permit holder is res onsible (or checking with apropriate 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 m ownership of the p site. This permit is subject to complian
the laws and Rules for Sewage Treatment and Disposal and to conditions of this permit e with the prov isions
c of
.
Construction Authorization
Required for Building_Permit)
The construction and installation requirements of Rules .1950, .1952,
with the attached system layout .1954, .1955, .1956, .1951, .1958. and .1959 are incorporated by references into this permit and shall be met Systems shall be installed in accordance
ISSUED T0: PROPERTY LOCATION: \ZIPI-)NC' L
SUBDIVISION LOT #
Facility Type: New ❑ Expansion ❑ Repair
Basement? ❑ Yes No Basement Fixtures? ❑ Yes D!9, No
Type of Wastewater System'` 90m -7o (:10,, , ,o N r, L
~t~ d GPD
(See note below, if applicable (Initial) Wastewater flow:
_ p U ~4 ~ o ~~~6r~ld ~ 4~t,-, (Repair)
Installation Requirements/Conditions Number of trenches
Septic Tank Size ►Op1Cs gallons Exact length of each trench 3~ feet Trench S acin
Pump Tank Size 4 ~ 0 gallons p g: C) Feet on Center
Trenches shall be installed on contour at a Soil Cover 6-1-~- inches
Maximum Trench Depth of. 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
inches below pipe
Conditions: Mt--E-,~ 0" S 7 E 'C ! s2, w \ Aggregate Depth: inches above pipe
cL 1a 1 N.5'SP~LLP~~\ C1N ~~2 ~ t~~, t_ La, o Q'S . ~ 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: /under land the system type oecified is different from the type specified on the app/ication. /accept the rpeci6cationr of this permit.
Owner/legal Representative Signature:
This Construction Authorization is subj Date:
oration if t site plan, plat, or the intended use changes. The (onstruction Authorization shall not be vansferred when there is a change in ownership of the site. This
Construction Authorizatio tt to comp wi of the Laws and Rules for Sewage Treatment and Dis osal and to dte conditions of this ermit
P P SEE ATTACHED SITE SKETCH
Authorized State Agent: (00146._'fOY-
Date: 5` \a
~Cmstruction Authorization Expiration Date: 8 s J
HTE# 1 O - 5-fit } Permit # 2., ~
Harriett Counter I ) pt l-fil tellt of Pt l bli c Health
S
"ite IV
-etch
V `l , S~az _ PROPERTY LOCATON_~yno ISSUED i0: cL$
SUBDIVISION LOT #
Authorized State Agent o~
Toy-Y.soo
g~- Date: _ s 14
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Department of EMimmnent. Health and Natural Resources
Division of ERvironmental Health Sheet;
On-Site Wastewater Section Property ID:
Lot l!:
SOIL/SM AVALUATIOrf File b:
for OM-SITE WASTRWATFU Svg", Code:
Owner. Applicant:
Address:
Date Evaluated: ?
tG
Location tm
D9APFlow(.1949): '
Fmpert)r Recorded:
Prop" Size:
Watex $uppty
Evaluatloa Method:
t ❑
❑ Well
rA
Borin
[I spring ❑ Other
Type of Wastewater
g ❑ pd
cut
wer
V ❑ Industrial Pr
~
ocess [
lVt
ix
ed
P
R
O
P
1 .1940
SOM MORPHOLOGY
.1941
Lawm" Haeizoe
E Pasidoe .194
OTHER
FiLa
PRO FACTO.s
ga)
Sl
.1941 .1941
So1
S "Ch" Conwdme
wetrled
143
.
1936
L5
-►o/a 0--3O
TO Mtmnlo Color
G
~5
5 SWO
CIA"
`J n~y~~v2
3C?-~
JBY- S<-2-
slo
~
G-7
c
V'f--~Y rrJ~N$
a~ sg~t 5cz
s
.1944 11 PIva
Re* Ctm
Harts. ALTAN
f5 ,L~
Atha Factor, (.1946
Site Classification (.1948) 5
EveluaEad gy;
Others Present;