IPACHTE# 1a- s Zs-2"--'L Harnett County Department of Public Health 26195
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: = r c Id.
ISSUED T S,+,4 cr~~
e.~ :~rn.~
SUBDIVISION
LOT #
NEW REPAIR ❑
EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: b
y8 3x ~2'
~
Proposed Wastewater System Type: Co 0L-1-t! ~04t,
Projected Daily Flow: -3( 10 G
GPD
Number of bedrooms:3
B
❑
21-
Number of Occupants: L max
asement
Yes
o
Pump Required: ❑Yes ❑ No
Q
MaaY'le required based on final location and elevations of facilities
~
Type of Water Supply: ❑ Community ;public 11 Well Distance from well feet Permit valid for:
? Five years
Permit conditions:
❑ No expiration
Authorized State Agent.: Date: _/G Zl! 12"e" t SEE ATTACHED SITE SKETCH
The issuance of this permit the Health Departmen o 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 wbject 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:t PROPERTY LOCATION: Id
SUBDIVISION kk a.. LOT #
Facility Type: New ❑ Expansion ❑ Repair
Basement? ❑ Yes No Basement fixtures? ❑,)(es ❑ No
Type of Wastewater System" C." (Initial) Wastewater Flow: GPD
(See note below, if applicable
Vfepair)
Installation Requirements/Conditions Number of trenches
Septic Tank Sized gallons Exact length of each trench (-,(3 feet
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of. ~ inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
Pump Requirements: ft. TDH vs. GPM
Trench Spacing: Feet on Center
Soil Cover: (P-~ inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
/ Aggregate Depth: _
Co ditlons:
~v,/ ~ ~f- 1 ear 1~ ff~ Q,••,. ~ r-~ ~
inches below pipe
a~ inches above pipe
inches total
*"If applicable: /understand the system type specified is different from the type speci>red on the app/icatian. / accept the specifications of this permit
Owner/Legal Representative Signature: Date:
nu wl-l-lull AuMuMdU1111 U wufeu to rerocamn n me sue plan, prat, or me mtenaeo use changes. the tonstrucuon Authonzahon shall not be transferred when there is a change in ownership of the site. This
lonstrucuon Authonzation is subject to comp!-We 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 161ylme Date: /I
Construction Authorization Expiration Date:
HTE# /C - J-- Permit # R k-' (R5-
Harnett County Department of 1'~ blic Health
Site Sketch
PROPERTY LOCATON: ~j ISSUED T0: c / r SUBDIVISION c 1 F,
LOT #
Authorized State Agent• ' Date: l
Q~/ @
r7
E
~v
Cot ~ycz
s~
~ f
t'
I f
!70
DeMriment of Environment, Health and Natural Resources Sheet:
Division of Environmental Health Property ID:
On-Site Wastewater Section Lot a:
File:
SOILJSTTL EVALUATION Code:
for ON-SITE WASTzWATEB SySTFM
Owner Applicant:
Addrew Date Evabud d:i
Proposed Facility: Deslgp Flow (.1949r Property Size:
Locadoe of Site: Property. Recorded:
Water Supply, Public ❑ Individual ❑ Well ❑ Spring ❑ Other
Evaluation Method: Auger Boring ❑ Pit ❑ Cut
Type of waswWater: sewage ❑ Industrial Process cl mixed
P
R
O
F
1
1940
OIL MORPHOLOGY
.1941
THER
MRMU FACTOR3
L
6
N
[auWk"
Posidow
Slope %
Haizun
DqA
(In.)
.1941
stud"
TOM"
.1941
ConaideM
Minm1o
.1943
9011
wema w
Color
.1943
sod
1N.
.1956
Sapro
Clap
.1944
Re*
Hams.
he&
CIM
R LTM
D+aaipdas
Available sp
s dais Tvv0
Site LTA
an .1943
s)
Initial Repair 3yatam Othar Factors I M4
system Site C1Md&adM (.1948X
Evetuated By:~
2 77 77
Others PrexnF»
-