IPACHTE# b _s Harnett County Department of Public Health 2 6 0 6 8
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
ISSUED TO: a--- PROPERTY LOCATION /YYL i~v c.. /0
_ SUBDIVISION h)j?,Kj n ,,.e LOT # _ /3'
NEW ❑ REPAIR EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: fX -~A:;>
Proposed Wastewater System Type: ~o►~t/4/fio~ c,~
Projected Daily Flow: _ ~(Qp GPD
Number of bedrooms: Number of Occupants: max
Basement ❑Yes lJ No
Pump Required: ❑Yes ❑ No Z ma be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community Public ❑ Well Distance from well feet Permit valid for. Z Five years
Permit conditions:
❑ No expiration
Authorized State A nt:: U Date: 8 - l Z - / d SEE ATTACHED SITE SKETCH
The issuance of this permit by a ealth Department in no way guarantees the issuance of other pe'rm'. The permit holder is responsible for checking with appropriate governing bodies in meeting their requirements. This
site is subject to revocation i e 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, .19% 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: ~j &e-f PROPERTY LOCATION:~!_
SUBDIVISION LJ LOT #
Facility Type: ❑ New C] Expansion Repair
Basement? ❑ Yes No Basement Fixtures? El Yes Z No
Type of Wastewater System**
(See note below, If applicable
IOP (Repair)
Installation Requirements/Conditions Number of trenches Z
Septic Tank Size ~xYz6d7 gallons Exact length of each trench 3 o feet
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of: J'5 inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
Pump Requirements: ft. TDH vs. GPM
(Initial) Wastewater Flow: - 3(,Q GPD
Trench Spacing: Feet on Center
Soil Cover. inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
Conditions: Aggregate Depth:
inches below pipe
inches above pipe
! I- inches total
**If applicable: /understand the system type specified /s d/!/erent /rom the type specified on the app/ication. /accept the fpeci>icatianr 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. This
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 Ag
Date: 6-/Z _ld
Construction Authorization Expiration Date: St'-/L -'-s'
HTE # /D - - Z lf0 5 PerKblic ZOO
Harnett County I)epartment of Health
Site ketch
PROPERTY LOCATON /W6 ~p
ISSUED T0: SUBDIVISION LOT # _Z -j-
Authorized State Agent
Date:
~
t~
c3
-x Pott-,/15
36'
Zp
, OO/
Department of Environment, Health and Natural Resources
Division of Environmental Health
On-Site Wastewater Section
SOIL/SITE, EVALUATION
for ON-SITE WASTEWATER SYSTEM
Owner. Applicant:
Address: Date Evaluated: 53-/D
Proposed Facility: Design Flow (.1949):
Location of Site: Property Recorded:
Water Supply: tic F1 Individual ❑ Well
Evaluation Method: huger Boring El Pit El
Type of Wastewater: 8-sewage ❑ Industrial Process ❑
Sheet:
Property ID:
Lot
File
Code:
Property Size:
❑ Spring ❑ Other
Cut
Mixed
P
R
O
F
1
1940
OIL MORPHOLOGY
.1941
THER
PROFILE FACTORS
L
E
#
Landscape
Position/
Slope %
Horizon
Depth
00
1941
Structure/
Texture
.1941
Consistence
Minemlo
.1942
Soil
Wetness/
Color
.1943
Soil
Depth IN.
.1936
Sapro
Class
.1944
Re&
Horiz
Profile
Class
dt LTAR
I
L air.
n
f4t~
2.
Lr Z°lv
O - lU
S`
1~.~,~-,atvo
1 Z « ~ t Y e~
Description Initial Repair System Other Factors (.1946):
system Site Classification (.1948):
Available 3 ace .1943 Evaluated By,
S stem T s
She LTAR Others Present: