IPACHTE# ~o-s x$53 Harnett County Department of Public Health
Improvement Permit 2 6 2 2 7
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: 0:5
ISSUED T0: gs c.>_..D
NEW "Ou"Murl _ Kf., E-FoVA) ,("1 LOT #
REPAIR ❑ EXPANSION ❑
Type of Structure: f^Vtan )-\Q Site Improvements required prior to Construction Authorization Issuance:
Proposed Wastewater System Type: 'k oucXwH Sys~(rn
Projected Daily Flow: GPD
Number of bedrooms: Number of Occupants: max
Basement ❑Yes No
Pump Required: ❑Yes 'XhVo ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community Public ❑ Well Distance from well t bO feet
Permit conditions: Permit valid for. Five years
❑ No expiration
A.~
Authorized State Agent:: Date: The issuance of this permit by the Health Department in no way guarantees the issuanc other permits. The permit holder s reln2 checking with appropriate governing SbodieATnAmHED SITE eT~tnenu. 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: ~c~c p ~L` L PROPERTY LOCATION: N C,~~OS
SUBDIVISION 9-Ni, o o Scr,--N A LOT # 1
Facility Type: Mf-," V\ome New ❑ Expansion ❑ Repair
Basement? ❑ Yes '>k No Basement Fixtures? ❑ Yes No
Type of Wastewater System** 5"/o yG-s~O,'J y5 EM
(Initial) Wastewater Flow: GPD
(See note below, if applicable
a5% R EOl)CA Q J-):~) r E~ (Repair)
Installation Requirements/Conditions Number of trenches 3
Septic Tank Size I COO O gallons Exact length of each trench t 00 feet
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of: V2, inches
(Trench bottoms shall be level to +1-114"
in all directions)
Pump Requirements: ft. TDH vs. GPM
Conditions:
Trench Spacing: q Feet on Center
Soil Cover. inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
inches below pipe
Aggregate Depth: inches above pipe
inches total
WATER LINES (INCLUDING IRRIGATIONS MUST BE LOFT. 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 apecired /.r different from the type fpecided 017 the app/i ,Wt 17. / accept the ,rpecircations of this permit.
Owner/Legal Representative Signature:
Date:
This Construction Authorization is subject t
rre~s lion if the sit 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 omphance wilt e the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit
SEE ATTACHED SITE SKETCH
Authorized State Agent: S1-C~`+as Date: S
Co ruction Authorization Expiration Date: -t
HTE#
Permit # 2.,6
1Ial-nett County I)epatlment of Public [tvajith
v i to S' ketell
PROPERTY LKATON: NC,~,~OS
ISSUED T0: S:1L\ IVISION amsroa o Sr•, LOT # 1
Authorized State Agent: ~S v Date: _
Department of EnvirouniprR Health and Natural Resourcea
Division of EnvironmeaW Health Shed:
On-Site Wastewater Section Property 1D:
Lot a:
SOQJSPPZ EVALUATION File N:
for ON-SITE wA9TEWATE Code:
II SYSTIi;iVf1
Owner Applicant
Addresr : Date Evaluated:" l LI) 1(3
proposed Factlltq: 'E,~ Doll Flaw (.1949Y ~►~go ~ p
Location of Sita
Property ropertp size.
watts sup*, Publk ~~ed
on Method: ❑ Individual Well C3 Spniag ❑ Ot6er
Type of Wastatratei; Auger Boring ❑ pn ~ cut Sewage ❑ Industrial Promn Mud
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1
.1940
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.1941
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1941
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1941
soil 1943
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site CI&Wxcados (.1948)
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er Preset
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