IPACHTE#/o-5=-A Harnett County Department of Public Health 2 618 8
Improvement Permit
A building permit cannot be issued with only an I provement Permit
PROPERTY LOCATION-
ISSUED T0: / ~ci<.c=✓p. SUBDIVISION LOT #
NEW ~i' REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: y.3 S .t
Proposed Wastewater System Type: CC-1, Ve-A % a
Projected Daily Flow: GPD
Number of bedrooms: _ Number of Occupants: IL max
Basement ❑Yes L Nci
Pump Required: ❑Yes ❑ No l 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. ET five years
Permit conditions: ❑ No expiration
Authorized State Agent: Date: T
'4Z,.r'/2q d SEE ATTACHED SITE SKETCH
The issuance of this permit by a Health 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: As' }p PROPERTY LOCATION' r Dn
SUBDIVISION v LOT # 00 IF
Facility Type: RT-~New ❑ Expansion ❑ Repair
Basement? ❑ Yes No Basement fixtures? ❑ s ❑ No
Type of Wastewater System** aa~'~+ti~' v (Initial) Wastewater Flow: 3% 6 GPD
(See note below, if applicable
Cdr de`1-(' C"'-V'- (Repair)
Installation Requirements/Conditions Number of trenches ,.,2
Septic Tank Size 000 gallons Exact length of each trench . '7,~-- feet
Pump Tank Size gallons Trenches shall be installed on conJtopr at a
Maximum Trench Depth of-, RY inches
(Trench bottoms shall be level to f/-1/4"
in all directions)
Pump Requirements: ft. TDH vs. GPM
Trench Spacing: Feet on Center
Soil Cover: j:1, inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
c~~r< :e ltc:wec.
Cr ,~~f
c,r F Qt A
inches below pipe
inches above pipe
f- inches total
**If 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 whiert to rrvnratinn if tha clm M- ~i,t nr 16n in,-A, a <o , , < U r _
. _.._..a--. ,m. - .~a„ - m- t.- u a I...%' ni uauenmp m me ate. rim
lonstruchon 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:
Construction Authorization Expiration Date: Glf
Aggregate Depth:
C c 0,/-c c./'.
HTE# Z° `3 =a2y/7„3 Permit # a6 L > 8
Harnett (bounty Department of I-~tblic Health
Site Sketch
-
PROPERTY LOCATON: ~t U~.
ISSUED T0: SUBDIVISION f LOT #
Authorized State Agent.. Date:C
IoY
Ic>
dofe-
~ I
3 obi
f
1 t~~- ~'h o f~~'lc~ fJ P d t
Department of Environment, Health and Natural Resources Sheet:
Division of Environmental Health Property ID:
On-Site Wastewater Section Lot 0:
SOUJSTTZ ZVALUATION File
:
for ON-SITE WASTEWATER SySTIM Cade:
Owner: Applicant:
Address Date Evaluata-
Proposed Facility: Design Flow (.1949r Property Size:
Location of Situ i Property tteoorded:
watex 3upw, ( iic ❑ Individual ❑ well ❑ slag ❑ aher
Evatu don Method: 1--Alger Boring ❑ Pit . Cut
Type of Wastewater: Sewage ❑ Industrial Process Mixed
P
R
0
F 30Q, NOM01,00Y
! .1940 .1941
gyp, Horizon
9 Positlow Depth .1941 .1941
M Slope 'A (ho 3trnohrt► Condde m
0,q6 I C,
OTHER
PROFILE PAC
.1941
Soil .1$43
We4tead T 9Wf
1956 .194 hom
39M PA* 0"
'Clan Hail. A LTAX
° - Site Classi8cadon (.1940
Evaluated By:
Others Present