IPACHTE# 10-5--Q~°VA Harnett County Department of Public Health
Improvement Permit 2 6 2 4 7
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: Ras) ~2.ip
ISSUED T0: F~~~ j INOc~~S SUBDIVISION Pv-:Z- Cf,NP~L LOT# _
NEW REPAIR ❑ %ANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: Yv1 A. r NlC) r-
Proposed Wastewater System Type: o 0.Lo>,v~ y ~J r sY
Proposed
Projected Daily Flow: 3(00 GPD
Number of bedrooms: Number of Occupants: max
Basement ❑Yes No
Pump Required: ❑Yes 'N~ No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community X Public ❑ Well Distance from well 1) O feet Permit valid for fve years
Permit conditions: L? No expiration
Authorized State Agent:: R~~S Date: ~g 1LS ~d SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees nce 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, .1956. 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: 1 0rnd•5 PROPERTY LOCATION: 1 J"d QZ
SUBDIVISION P,v c C-- V,t, LOT #
Facility Type: New ❑ Expansion ❑ Repair
Basement? ❑ Yes X No Basement Fixtures? ❑ Yes 'XNo
Type of Wastewater System** a5V o ~.1=oUC sVe) N `3 -J 5-~ L rn
(initial) Wastewater Flow: aC) GPD
(See note below, if appficable',Z, aSOJo n..C: o u cl'~ ~n ,J S 157 E c) (Repair)
Installation Requirements/Conditions Number of trenches
Septic Tank Size s O oo gallons Exact length of each trench _ 5 feet Trench Spacing:
feet on Center
Pump Tank Size gallons Trenches shall be installed on contour at a Soil Cover la= aL1 inches
Maximum Trench Depth of. a"~A `3j + inches (Maximum soil cover shall not exceed
(Trench bottoms shall be level to +/-1/4" 36" above the trench bottom)
in all directions)
Pump Requirements: ft. TDH vs. GPM inches below i e
Conditions:
Aggregate Depth:
rr
inches above pipe
inches total
WATER LINES (INCLUDING IRRIGATION) MUST BE LOFT. FROM ANY PART OF SEPTIC SYSTEM OR REPAIR AREA.
NO UTILITIES ALLOWED IN INITIAL OR REPAIR DRAIN FIELD AREA.
**If applicable: l understand the system type specified it different from the type .rpecih'ed on the application. / accept the specifications of this permit.
Owner/Legal Representative Signature: Date:
Tbi, r---i,,,, .....L;.
X1-1 - ,.•°-°1•°° r'u", r- - - -nalig- ina ~unwuuiun sumuncauon snap or oe transterrea when mere is a change in ownership of the site. This
construction Authorization is subject to com a provi of the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent: RL-l~S Date: $ a 0
struction Authorization Expiration Date: $ 1~
HTE# Permit #
fl< l-Nett County 1)eptirfinent of Mtblic livaltit
site shetch
PROPERTY LOCATON:
ISSUED TO: SUBDIVISION y c. Govrat. LOT # ~1
Authorized State Agent: 6 L-)d Sa t,tcs cw<2~ Date: )%I, ~
_ 5 y S'~ Lm A2G- Pt
Uo~~
L-~A~~
X04
Ia ~ G'f~
35"
Department of Environment, Health and Natural Resources
Division of Environmental Health
On-Site Wastewater Section
SOE JSITZ &VALUATION
for ON 41T& WAS'TMATER SYSTE
Owner. Applicant:
Address: Date Evaluated:
Proposed F=Wtp: 1 5 Desigs Maw (.1949):
Location of Sift Propetttt Recorded:
Water $npp j He ❑ Lldividual ❑ Well
EVAMon Method: Auger Boring ❑ Pit
Type of Washm ater Sewage ❑ Irdustriai PMM
Sheet:
Property ID:
Lot
File *
Code:
Propertp Size:
❑ Spring ❑ Other
Cut
Mixed
P
R
O
F
1
1940
oumORPHOLDGY
.1941
THER
PItOFIER FACTOR3
L
9
N
L.and"pe
Poeitiow
Slope
Haizow
DqA
(Ia.)
.1941
3ttuaww
Textan
.1941
Comirtnq
Mlawwo
1941
304
Welled
Color
1043
sail
QV.
.1956
sepre
Clan
.1944
RAW
Hart
PM&
CIAO
A LTAX
L
oa~,~
cy~34
LS
4K
"7--
o ~
6 Lf
Yrrn-
z,~
~Q s
~i~n ss
96
Ma Factors (.1946)
Site C1aWcation (.1948) 5
Evalueted By:
Others Ptex*
p -3 i,