IPAC RHTE# y 0 5~ asp ~a Harnett County Department of Public Health
Improvement Permit 2 6 2 8 4
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: ~w~J a10
ISSUED TO: G txz y ~A DcwE~ SUBDIVISION G, LOT # _
NECK REPAIR ❑ NSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: SV9 (3 y~~
Proposed Wastewater System Type: 2~ e P, R F-0 uvst oN y5-rt~, t'-r'
Projected Daily Flow: CJ GPD
Number of bedrooms: Number of Occupants: C, max
Basement ❑Yes No
Pump Required: ❑Yes ❑ No May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community --I~ Public ❑ Well Distance from well l 00 feet Permit valid for. Five years
Permit conditions: ❑ No expiration
Authorized State Agent:: Date: \ cs~ s~16 SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the issuan other permits. The permit holder s 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: GA40-1 Q-A ge\ .isont Nom Es PROPERTY LOCATION: N~ wy 214
SUBDIVISION Gw~N Oo,~t3 LOT #
Facility Type: Sip C3y x~s~ New ❑ Expansion ❑ Repair
Basement? ❑ Yes ~X No Basement Fixtures? ❑ Yes -No
Type of Wastewater System- aS°Jo ~~o ucct O N Sy STS, c ~ (Initial) Wastewater Flow: GIRD
(See note below, if applicable
3..;"jo 42EOuG-~ t cs i s Sy~7~r<` ~Qg!n*epair)
Installation Requirements/Conditions Number of trenches I
Septic Tank Size OoC gallons Exact length of each trench QS(`} feet
Pump Tank Size `040 gallons Trenches shall be installed on contour at a
s r Nr-- Eon Maximum Trench Depth of: aL~ - 3b Inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
Pump Requirements: ft. TDH vs. GPM
Trench Spacing: 1 Feet on Center
Soil Cover: 13--113' inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
inches below pipe
Aggregate Depth: inches above pipe
Conditions: Oco Na\ SrnEt<L S X06 c tats o2~rt>=~,c~. ~On, Qc,~z -S
inches total
li= tNC c-c 5zt - 1'ti S~C C~.t Ss cE` ~o c3o,r_~2E 1. -Ioy i P~r?jn : 'is A4E,Z O , Pci(1Pos~,L
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: /under understand the system type specified is diNerent from the type specified on the app/icafion. /accept the speciflcationt of thin 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 chill not ha t-forrnd Wh.n rho.....h- . ;..m.. A;..f a,..;.. TL;.
Construction Authorization is
Authorized State Agent:
- _...r
to compliance r ovisions the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
C,&\A.s
Date:
on Authorization Expiration Date: to
HTE# I C> - S -aS S9 COR, Permit #
Harnett County Department of Public Health
Site Sketch
PROPERTY LOCATON: SA ,,4 y )-A D
ISSUED TO: Gam. r.so oro~ s SUBDIVISION G~-•~~s C)g, 5 LOT # \ A
Authorized State Agent: -~s ~a ~yb2 -soLV.~oo Date: IC) l 10 T
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Department of Environment, Health and Natural Resources
Division of Environmental Health
On-Site Wastewater Section
SOUJSITZ ZVALUATION
for 014-S1TZ WASTZWATICit SYSTM
Owner. Applicant:
Address
Proposed Facility:
Location o( site`
Watet Sup*
Evaluation Method:
Type of Wastewater
Date Evaluated:
Design Flow (.1949r
PmOody 11 corded:
Sheet:
Property 1D:
Lot #
File
Code:
Property Size-
U Public ❑ Individual ❑ Well ❑ Spring
H Auger Boring ❑ Pit cut
Sewage ❑ Industrid Process [9 mud
❑ Other
r
R
0
F
301L NORPHOL00Y
t 1940
L Lartd~ca
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i
.1941
PROFILE pACTOR3
p
or
zon
B Posi" D"*
.1941 .1941
1943
Solt
1043
3lo" % 00
3trucftw Coesisteme
wet uaw
.1916
_
9
.194#
Re*
PtoA1.
CIM
Texh" uinumfo
Color
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DeeQlPdom lnitW Repdr System Other Factors (.1946)
s e
wellable9 ace .1945 Site Clessilkadou (.19411)
P S
S sum Evehated By: cr
3h. LTAlt , Others Present:
<ac~C~ ~~-30
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