IPACHTI# /0 -S-- ZS_"08e Harnett County Department of Public Health 2 6 1 9 0
Improvement Permit
A building permit cannot be issued with only an Improvement ermit
PROPERTY LOCATION:
ISSUED T0: ~.6 SUBDIVISION 1 rt-cti, ,hr LOT # ~
NEW PK R AIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure:
Proposed Wastewater System Type:
Projected Daily Flow: J L 6 GPD
Number of bedrooms: J Number of Occupants: L max
Basement ❑Yes I NN_o
Pump Required: ❑Yes L~t'No ❑ Mae required based on final location and elevations of facilities
Type of Water Supply: ❑ Community 0 Public ❑ Well Distance from well feet Permit valid for. 12-f e years
Permit conditions:
❑ No expiration
Authorized State Agent:: Date: `z 2°ics SEE ATTACHED SITE SKETCH
The issuance of this permit byte Health Department in no way guarantees the issuance of other permits. The permit holder is responsible for checking with approprate 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, AM, .1954, .1955, .1956, .1957, .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:r*r PROPERTY LOCATION:
SUBDIVISION ~Cc acv l LOT #
Facility Type: r _ 1~ New ❑ Expansion ❑ Repair
Basement? ❑ Yes No Basement Fixtures? ❑ Yes ❑ No.
Type of Wastewater System*~~ (Initial) Wastewater Flow: GPD
(See note below, if applicable y '
o~ Sal o ~c c-= xl`{-c.~ . _ ( alr)
Installation Requirements/Conditions Number of trenches 0Z ®,r
Septic Tank Size l0G 0 gallons Exact length of each trenchC eet
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of. /o d- C inches
(Trench bottoms shall be level to +1-114"
in all directions)
Pump Requirements: ft. TDH vs. GPM
Trench Spacing: Feet on Center
Soil Cover: finches
(Maximum soil cover shall not exceed
36" above the trench bottom)
t
Aggregate Depth:
tc .Etch/ ~A 8~
inches below pipe
inches above pipe
inches total
141- **If applicable: /understand the syrtem type specified is different from the type specified an the app/kwon. / accept the soec16c3tionr of this permit
Owner/legal Representative Signature: Date:
This Construction Authorization is subject to revocation 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
Cl
Authorized State Agent Date:
Construction Authorization Expiration Date: S q 2 61 -
H T E # %C-
Permit # o~ I c1 Q
Harnett County Department of Public Health
Site Sketch
PROPERTY LOCATON: 'ed
ISSUED T0: sr SUBDIVISION ~~e~ e•~`~~> s~J LOT
Authorized State Agent I-e Date: ` l Y/ "f~
4
70
ddor
i I
g~
Za
UCpd11111C11L UI CIIVII UIIIIICiII, f1CdlL11, d11U IVdWldl rlCJUUIUCJ JIICCI.
Division of Environmental Health Property ID:
On-site Wastewater Section Lot
File
SOILiSITE EVALUATION Code:
for ON-SITE WASTEWATER SYSTEM
Owner: Applicant:
Address: Date Evaluated:
Proposed Facility: Design Flow (.1949): Property Size:
Location of Site: Property Recorded:
Water Supply: [-f1public [ ] Individual [ ] Well Spring [ J Other
Evaluation Method: [ 4"A' uger Boring [ ] Pit [ ] Cut
Type of Wastewater: I wage Industrial Process [ ] Mixed
P
R
O
SOIL MORPHOLOGY
OTHER
F
.1941
PROFILE FACTO
1
.1940
1942
L
Landscape
Horizon
.1941
.1941
Soil
.1943
7
.1944
Profile
E
Position/
Depth
Structure/
Consistence
Wetness/-
Soil
SIapro
Restr
Class
#
Slope%
(IN.)
Texture
Mineralogy
Color
Depth (IN.)
Horiz
R LTAR
l
Description
Initial System
R it System
Available Space (.1945)
System Type(s)
,
ISite LTAR
Other Factors (.1946)
Site Classification (.1948):
Evaluated By:
Others Present: ,!j ~Q