IPAC RHTE# ./d -J = aY6 Ye 2 Harnett County Department of Public Health 26191
Improvement Permit
A building permit cannot be issued with only an I rovement Permit
f~ PROPERTY LOCAT%:" ~J
ISSUED TO: Wt SUBDIVISION r.. S4 LOT # (12
NEW REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: 0 J ~O & 0
Proposed Wastewater System Type: g s;'y it
~w-
Projected Daily Flow: GPD
Number of bedrooms: Number of Occupants: L max
Basement ❑Yes / ER40
Pump Required: 6es ❑ No ❑ Mape required based on final location and elevations of facilities
Type of Water Supply: ❑ Community e Public ❑ Well Distance from well feet Permit valid for. E~- five years
Permit conditions: ❑ No expiration
Authorized State Agent::
f
Date: SEE ATTAINED SITE SKETCH
The issuance of this permit by Health Department in no way guarantees the issuance of other permits. The permit hol er 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: PROPERTY LOCATIO : cs% Kl
SUBDIVISION pfd LOT # 5/ Z -
facility Type: ,r c4~7 p f" New ❑ Expansion ❑ Repair
Basement? ❑ Yes ❑ No Basement Fixtures? ❑ Yes ❑ No
Type of Wastewater System" 0,~,,,, { o C ~1 Jc~~~E. ~ (Initial) Wastewater Flow: ~ L c GPD
(See note below, if applicable
(Repair)
Installation Requirements/Conditions Number of trenches
Septic Tank Size CaC gallons Exact length of each trench O q
~feet Trench Spacing: feet on Center
Pump Tank Size / gallons Trenches shall be installed on contour at a Soil (over r2 inches
Maximum Trench Depth of: 0~ V inches (Maximum soil cover shall not exceed
(Trench bottoms shall be level to +1-114" 36" above the trench bottom)
in all directions)
Pump Requirements: ft. TDH vs. GPM C inches below pipe
A regate Depth: 21 inches above pipe
Conditions:~u wee 1 , ~c tfc°~ ~c ~c,c~ inches total
C-~
If applicable: l understand the system type specified is diNerent from the type specified on the application. l accept the specifications 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
in ownership of the site.
Construction Authorization is subject to compli a 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- C, a Date: C Zc/
Construction Authorization Expiration Date: I ( C/J-
NTE# Permit # k f
Harnett (county Department of Public Health
Site Sketch
PROPERTY LOCATON: "
ISSUED TO: SUBDIVISION Wn LOT #
Authorized State Agent. Date:
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Department of Em ronment, Health and Natural Resources
Division of Environmental Health
On-Site Wastewater Section
SOEUSffZ EVALUATION
for ON-SITE WASTEWATER SYSTE1*4'
Owner. Applicant: /
Addre=
PToWsed Facility:
Location of Site:
Water 3uppt
Evaluation Method:
Type of Wastewater:
Date Evaluatedr, 1 ~
Desip Flow (.1949r
Pro" Recorded:
Sheet:
Property 1D:
Lot 11:
File M:
Cade:
Property size:
[,Public ❑ Individual ❑ well ❑ spring
Auger Boring ❑ Pit Cut
Sewage ❑ industrial Process mixed
❑ Other
P
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1940
OIL IMORPHOLO0Y
.1941
THER
PROFILa PACTOR3
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Depol .1941 .1941
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.1941
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soil
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.1956
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.1944
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Mar Factors (.1946k
Site ClaWcadon (.1948
Evaluated B)rA
Othas Prew*