IPAC RHTE#./o - - aY iY- 4 Harnett County Department of Public Health 26183
Improvement Permit
A building permit cannot be issued with only an Improvement Permi
PROPERTY
ISSUED TO:
SUBDIVISION ~r f
LOT # 1,2
NEW G~'_
REPAIR ❑
EXPANSION ❑ ite Improvements required prior to Construction Authori
zation Issuance:
Type of Structure:
'F 0)
) i
Proposed Wastewater Sy
stem Type:
'J ,
Projected Daily Flow:
L3 cc,,
GPD
Number of bedrooms:
3
Number of Occupants: max
Basement ❑Yes
LKO
Pump Required: ❑Yes
❑ No
12/Maybe required based on final location and elevations of facilities
Type of Water Supply:
❑ Community
Public ❑ Well Distance from well feet Permit valid for
1"I Five years
Permit conditions:
❑ No expiration
Authorized State Agent.: Date: SEE ATTACHED SITE SKETCH
The issuance of this permit by t ealth Department Inn y guarantees the issuance of other permits. The permit 1t61der 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 ASC, .1952, .1954, ASS, .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. j
ISSUED TO: PROPERTY LOCAT N: C t_-C" Z New c,1 LOT #
Facility Type: L~" New ❑ Expansion ❑ Repair
Basement? ❑ Yes 12/No Basement Fixtures? ❑ Yes Np
Type of Wastewater System' V20~m Jr- i`te- (Initial) Wastewater flow: 50-1 GPD
(See note below, if applicable
5~ a X'4.4- sn, ~',_e~ (Repair)
Installation Re uirements/Conditions Number of renches
Septic Tank Size cSGC~ gallons Exact length of each trench feet
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of. _Linches
(Trench bottoms shall be level to +/-1/4"
in all directions)
Pump Requirements: ft. TDH vs. GPM
Conditions: c, <<1~ oti ter` a-a
G r
Trench Spacing: Feet on Center
Soil Cover: inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
inches below pipe
Depth: inches above pipe
inches total
I*"-
PC 6 c yo,
c}€`~
*If applicable: understand the rystem type specified is different from the type specifed on the app/rows fl, / accept the specifications of thin permit
Owner/Legal Representative Signature: Date:
This Construction Authorization is subject to revncarinn if rho dto nlan nht nr t6o mt dod A-., T6a r ...,,a A.,d..:,,« . „u u.. -.r...
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 Agent: Date: 8 10
Construction Authorization Expiration Date:
HTE # l0 aY C ~5- 4 Permit # a- S° ( t ~7
Harnett County Department of Public Health
Site Sketch
ISSUED TO: ~ ~
Authorized State Agent:
PROPERTY LOCATON: C F~~•~~
SUBDIVISION LOT #
1Mf _ Date: 5 l 1 n
Qz~; ~Y o ;sal ~C f jf4c.I&`'1-tfe
Department of Envimnmmt, Health and Natural Resources
Division of Environmental Health
On-Site Wastewater Section
SOELJSIT1i: EVALUATION
for ON-SITZ WASTEWATZR SYSTEM
Owner. Applicant:
Addresf•:
Proposed Fatall r.
Location of Sit=
Watdt suppll:
Evaluation Medod;
Type of Wastewater:
Date Evalu*d- 7
Design Am (,1949Y
Property Recorded:
lk ❑ Individual ❑ Well
gar Boring ❑ Pit ❑
Saewage ❑ Industrial Process[
Sheet:
Property 1D:
Lot H:
File *
Code:
Property Size:
❑ Spring ❑ Other
cit
mixed
P
O
F
1
1940
SOUL MORPHOLOGY
.1941
OTHER
PAOFILa FACTORS
L
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it
heap
Posidod
Slop[ %
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Depdr
(In.)
.1941
stuoh"
Test
.1941
Considam
mime
.1942
soil
wafted
Cola
A47
soil
Diyd IN.
.1956
SWO
Clan
.1944
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D+wipdaa WW Rapdr sydem Otha Factors (.1946k
s ate 9ita Clas i$cadan (.1940- f
Available 9 a .1941 2 0 ~ tedByA I-
s abq e r
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