IPAC RHTE# ~~e aye J) /Z Harnett County Department of Public Health 2 61 7 8
Wrovement Permit
A building permit cannot be issued with only an Improvement Permit
n PROPERTY LOCATION: P'e a_,; zs-- /cf
ISSUED T0: l~n Li SUBDIVISION LOT #
NEW V' REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: S' D )_!~4 60
Proposed Wastewater System Type: C Q-A- k/
Projected Daily Flow: C~ GPD
Number of bedrooms: 3 Number of Occupants: fO max
Basement ❑Yes C" No
Pump Required: ❑Yes ❑ No Ma e required based on final location and elevations of facilities
Type of Water Supply: ❑ Community blic ❑ Well Distance from well _100- feet Permit valid for. L'-Five years
Permit conditions: ❑ No expiration
Authorized State Agent: Date: ss- ~%/mil t~-'- SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in ay guarantees a issuance of other permits. The permit holderle r 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: Cr- PROPERTY LOCATION: ~t Ad,
SUBDIVISION LOT # AZW
Facility Type: 2"'New C~ Expansion ❑ Repair
Basement? ❑ Yes 5/No Basement Fixtures? ❑ Yes No
Type of Wastewater System' C_c✓L~~~ %c 'Q_ (Initial) Wastewater Flow: GPD
(See note below, if applicable
c Z5-1-, (Repair)
Installation Requirements/Conditions Number of trenches J
Septic Tank Size gallons Exact length of each trench 6'6 feet
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of: inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
Pump Requirements: ft. TDH vs. GPM
Trench Spacing: Feet on Center
Soil Cover: -L:=inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
/Aggregate Depth:
Conditions:.. l~4Cl c cjl-
c1 Jr- l ~C-pQ2, r rc~l l k_-~".. ' ~f ~t f f ~e cal- w`f /cy
inches below pipe
c_ inches above pipe
inches total
e:c ~ca
Hl applicable: / understand the system type specified is different from the type specified on the app/ication / accept the specifications of this 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.
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: cr..~ Date: g/1) 11n i
Construction Authorization Expiration Date:
HTE# 2-'-y` 7 ~ 2 9 Permit # o?, 1, 17 8
Harnett County Depar(ment of Public Health
Site Slketch
` I PROPERTY LOCATON: 41.
ISSUED T0:~ (c~c t SUBDIVISION LOT # 12-d
Authorized State Agent: ,Z
Date: } / f
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Department of Environment, Health and Natural Resourm
Division of Environmental Health
On-Site Wastewater Section
SOIIJSITZ EVALUATION
for ON-S1TIS WASTIEWATElt SYSTEM.
Owner Applicant:
Address:
Proposed FWWtr
Location of Situ
Water Snp*
Evaluation Method:
Type of Wastewater:
Date Evaluated: 'I
Design Flow (.1949 :
Property Recorded:
Sheet:
Property ID:
Lot 1►:
File
Code:
Pmperiy Size:
❑ llc ❑ Individual Elwell ❑ Spring
ger Boring ❑ Pk cut
3 Sewage [I Industrial Process mixed
❑ Other
P
R
O
F
1
1940
OO. IMORPHOLOOY
.1941
THER
PROPU FACTOR)
L
9
4
larAm app
Poeitlael
Slope %
Horhm
Depth
00
.1941
souoh"
Texh"
.1941
ConWda M
Minrdo
.1941
Soil
Wd Wmd
Color
.1043
Soil
DiVA IN
.1916
3"m
Clan
.1944
Reap
Hails.
PMMI
CI M
A LTA]R
i/4-
All-
Ac 1/
6ff5;000
,
z -~y fVf j
.-.....r,,,.,4 u aw KePaN sYdem Other Fedor (.1946k
s a~ SiteClamflcadon Available s as ,19451948k f
s a.rs a Evahwted B)V---
site LT,+►l; r Others Ptem*