IPACHTE#kC)-5--J 0
Harnett County Department of Public Health
Improvement Permit 2 6 2 6 0
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION:_ ~L Q ~N C: 0(1--
ISSUED TO: cvH C Q rnt',~ ,-13 415 SUBDIVISION 5 y mM LOT # l_
NEWX REPAIR ❑ EXPnION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: '5 TO (1-"LA,'--
Proposed Wastewater System T pe: Cv" -f
Projected Daily Flow: 3 b GPD
Number of bedrooms: _ Number of Occupants: max
Basement ❑YesNo
Pump Required: ❑Yes -'KNo ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community Public ❑ Well Distance from well b feet
Permit valid for. ~ive years
Permit conditions:
❑ No expiration
Authorized State Agent:: Date: 1 > SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the issuance er permits. The permit holder is respons le for checking with appropriate governing bodies in meeting their requirements. This
site is subject to revocation d 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)
with The the construction attached and system layinstallatiouont. requirements of Rules .1950, .1951, .1954, .1955, 955. .1951, .1958. and .1959 are incorporated by references into this permit and shall be met. Systems shall be installed in accordance
ISSUED TO: C, l t•,c,,~ r., C> S
Facility Type: XIS-0 X New
Basement? ❑ Yes No Basement Fixtures? ❑ Yes
Type of Wastewater System' G
PROPERTY LOCATION: P~Le
SUBDIVISION S y rnr, LOT # 1
❑ Expansion ❑ Repair
-XNo
(See note below, if applicable
'-4 Y E.~ o N F" I- (Repair)
Installation Requirements/Conditions Number of trenches
Septic Tank Size L O O cs gallons Exact length of each trench )i ~ o feet
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of., 1~ '3 b inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
Pump Requirements: ft. TDH vs. GPM
Conditions:
(Initial) Wastewater Flow: -~O GIRD
Trench Spacing: C) Feet on Center
Soil Cover ~ ' l $ inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
(:1 inches below pipe
Aggregate Depth: _ inches above pipe
_ 1A inches total
WATER LINES (INCLUDING IRRIGATION) MUST BE ]OFT. FROM ANY PART OF SEPTIC SYSTEM OR REPAIR AREA.
NO UTILITIES ALLOWED IN INITIAL OR REPAIR DRAIN FIELD AREA.
"If applicable: /understand the system type specified is different from the type specifed on the app/ication. /accept the rpecir2ationr of thin permit.
Owner/Legal Representative Signature: Date:
This Construction Authorization is subject to rev if the site an, 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 Authonzation is subject to compliance the p ns a Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent: Date: 7 10
Cons uuction Authorization Expiration Date: 7 a.
HTE# 10-s-asO~,3 Permit # 'D47, 5
Harnett County Department of Public Health
Site Sketch
PROPERTY LOCATON: Ai-P Irv G- V~L
ISSUED T0: SUBDIVISION 5v M r•, cT LOT # Za.
Authorized State Agent: +5 pL vC-,L-To Lv_ 0 Date:
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{?Mslon of Environmental Health
n-site Wastewater Section
SOILISITE EVALUATION
for ON-SITE WASTEWATER SYSTEM
Property ID:
Lot
File fit:
Code:
Owner.
Address: "leant:
PrOPOSed Facility. 3 ~~~c1d Design Flow (.1949): 34 (y
Lodatlon of site:
Water Suppy: j Public [ j Individual WON
Evaluation Method: ALVer Borft (j Pit
Type of Wastewater: 'l-Y-3ew%le ) j industrial Process
Date Evaluated:
Property Size:
Property Recorded:
[ 1 SPrft
[ ) cut
f 1 ulw MI
1 1 Ofhar
miaai 5 stem epalr system
Other Factors (.1948):
Available S ace (.1945) Site Classification (,1948):
System T (s) Gu jj C, C,
Evaluated By:
Site LTAR g
Others Present:--