IPAC RHTE# Harnett County Department of Public Health 2 6 1 8 4
Improvement Permit
A building permit cannot be issued with only an Improveme t Permit
ISSUED TO: PROPERTY LOCATION- cz- 1` d
NEW ~ SUBDIVISION hl-rA LOT _
REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: FJD qd'I( S"p
Proposed Wastewater System Type: _pZS%,ecQu c~ Ylf4.
Projected Daily Flow: 3(a Q GPD
Number of bedrooms: Number of Occupants: max
Basement ❑Yes C'~lo
Pump Required: ❑Yes L' No ❑ May ,be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community Public ❑ Well Distance from well feet
Permit conditions: Permit valid for 0IFive years
❑ No expiration
Authorized State Agent:: /u e
Date: SEE ATTACHED SITE SKETCH
The issuance of this permit by the ealth Department in no way guarantees the issuance of other permits. The permit holder 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 .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: _"f c,,- ;,;PROPERTY LOCATI N: ~cr4
SUBDIVISION Y_c~",d
Facility Type: ,w!
LOT #
ld' New 11 Expansion ❑ Repair
Basement? ❑ Yes VNo Basement Fixtures? ❑ Yes No
Type of Wastewater System**~a
(See note below, if applicable (Initial) Wastewater Flow: GPD
-9J-.7", k 4..f 't6 - (Repair)
Installation Requirements/Conditions Number of trenches -3
Septic Tank Size Cd 0 gallons Exact length of each trench feet
Pump Tank Size gallons Trenches shall be installed on conto}r at a
Maximum Trench Depth of: ` inches
(Trench bottoms shall be level to +/-1/4"
Pump Requirements: ft. TDH vs.
Conditions: ,L er git Cc
in all directions)
GPM
Trench Spacing: Feet on Center
Soil Cover: 12- inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
inches below pipe
pp Aggregate Depth: inches above pipe
i ches total
-iv applicable: / understand the ryrtem type ,rpeciped it different from the type rpecifled on the app/icatioo. / accept the rpecificationf of thin permit.
Owner/Legal Representative Signature:
Date:
This Construaion Authorization is subject to revocat on 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
z C -
Authorized State Agent
4 e Date: _
L99 -
Construction Authorization Expiration Date:
HTE# Permit # 1
Harnett Clounty Depailinent of 1' iblic Health
Site Sketch
PROPERTY IOCATON:ctr Pl
ISSUED T0: ~~~►.-~c ~~rc~ ~~,;~p~ / SUBDIVISION LOT
Authorized State Agen Date: 1 13
GG~ ~Qe~ J/~.~t
4~.
Q f
a
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Divie sn oft O Envi~nnmk Health and Natu W Resourcea sheet
ronmentai Health
On-Site Wastewater Section Property ID:
Lot M:
SOE1JSM EVALUATION File M:
for ON-g1TE xw Code:
T& vvATEj%9Y9TE 4
Owner. Appncant:
Addresic Date Evaiuatai: 6 r
Proposed Facility:
Location of Site;
DeAP Ftcw (.1949Y
Fmperi)r Recorded;
Property size:
water su
Evaluation Method:
C3'Pub1 c ❑ fixbidu l ❑ Wen
❑ Spring
Type of wastewater:
psemige ger Boring ❑ Pk
❑ Industrial Process
cut
Mixed
P
l;
P
1 .1940
SOM'WORPt LOGY
OTHER
L Apr
Hafus
.1941
PRO-y"
FACrOR7
POSMOW p Slope K ~ A
1941 .194
.1941 S~
sa
r
n
.
1
..1043
uo
r
conwdam webmw
Ted Mlanlo Cola
sat
KEE I Et 7"~4
1&&i vry,
r s° ~l .srl ~i-ff S,
❑ Other
.1956 .1944 ftwu
SWO Redr can
Clam- I Haas. A LTA
/.J(s-
,6
.f
VERN Factors (.1946)
~-fSiteClauiflE~ 43)ff
5 - Others Prem*