IPACHTE#116 -s -5bg5- Harnett County Department of Public Health 2 6 0 7 3
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: ='of, /94~6 i A6--k ,a4l- 17-4
ISSUED TO- ~AZ0 /54J. SUBDIVISION r:.,~,yj~,, LOT #
NEW REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: S
Proposed Wastewater System Type: 2S%I1-ri-►~
Projected Daily Flow: 3100 GPD
Number of bedrooms: 3 Number of Occupants: max
Basement ❑Yes
Pump Required: ❑Yes I~ No ❑ 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. f~ Five years
Permit conditions: ❑ No expiration
Authorized State Age Date: 9-Z:5-'I) SEE ATTACHED SITE SKETCH
The issuance of this permit b e 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 T0: T~ PROPERTY LOCATION: 5Z /4,0 X5-4vs '
1 SUBDIVISION LOT
Facility Type: t W New ❑ Expansion ❑ Repair
Basement? ❑ Yes No Basement Fixtures? ❑ Yes 21 No
Type of Wastewater System` Z5%fliRUc4-7in1 5 (Initial) Wastewater Flow: 360 GPD
(See note below, if applicable
Z i_^ (Repair)
Installation Requirements/Conditions Num er of trenches W Z
Septic Tank Size 1600 gallons Exact length of each trench ILC~> feet Trench Spacing: Feet on Center
Pump Tank Size gallons Trenches shall be installed on contour at a Soil Cover. - inches
Maximum Trench Depth of. Z(-4 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 pipe
Aggregate Depth: L inches above pipe
Conditions: /Z inches total
**If applicable: / understand the system type specified is different from the type specified on the app&dtiom / accept the specifications of this permit.
Owner/Legal Representative Signature: Date:
,u--, - . -J- w w -utiu it um lire Pian, piar, or me mcenaeo use cnanges. ine construction Autnonzabon 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 ATTACHFn SITF (KETCH
Authorized State A t: Date:
Construction Authorization Expiration Date: 8-ZS =is-
HTE# J6-5-- Z5-b ` 'S- Permit # 260 ? .3
Harnett County Department of FVblic Health
Site Sketch
PROPERTY LOCATON: YjG6
ISSUED TO: fs3-sr2 6lijAa 941J3_ SUBDIVISION 77, IoK LOT # Z
Authorized State Ag Date: $ Z S = t
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givlsion of Environmental Health Property ID:
`,'n-site Wastewater Section Lot #
File
SOUJSITE EVALUATION Code:
for ON-SITE WASTEWATER SYSTEM
Owner. Applicant:
Address: Date Evaluated: 09-2,;r'6
Proposed Facility: Design Flow (.1949): 3ee',~ Property Size:
Location of Site: ~,t (y(10 Property Recorded:
Water Supply: [ individual [ )We* Spring Other
Evaluation Method: [ Auger Boring Pit [ )cut
Type of Wastewater: ( bfewage Industrial Process [ ) Mixed
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Description
Initial System
Repair stem
Available Space (.1945)
System Ty e(s)
Z,f°!o
Lam,
ISIte LTAR
Other Factors (.1948):
Site Classification (.1948): i0s
Evaluated By:`
Others Present: