IPAC RHTE# Harnett County Department of Public Health 26196
Improvement Permit
A building permit cannot be issued with only an Improvement ermit
/ PROPERTY LOCATION: O Jc~~
ISSUED TO: C rc._ T~ n t4-QL SUBDIVISION LOT #
NEW V REPAIR ❑ -EXPANSION ❑
Type of Structure: SF-6 ~lv~ y l c
Proposed Wastewater System Type: 47t(
Projected Daily Flow: • 3 y GPD
Number of bedrooms: 3 Number of Occupants: L max
Basement ❑Yes VNo
Pump Required: ❑Yes Li? No ❑~Mae required based on final location and elevations of facilities
Type of Water Supply: ❑ Community L Public ❑ Well Distance from well feet
Permit conditions:
Site Improvements required prior to Construction Authorization Issuance:
Permit valid for:
P-1 Five years
❑ No expiration
Authorized State Agent.: _ ILA--I ~ ~//6 (7v_ Date: - SEE ATTACHED SITE SKETCH
The issuance of this permit by thrl$Kldi Department in no 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 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 taws 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, .1951, .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: PROPERTY LOCATION: old &'?t
SUBDIVISION LOT #
Facility Type: New ❑ Expansion ❑ Repair
Basement? ❑ Yes li4 No Basement Fixt res? ❑ Yes ❑ No
Type of Wastewater System** 7 : (Initial) Wastewater Flow: GPD
(See note below, if applicable
(Repair)
Installation Requirements/Conditions Number of trenches C Kr
Septic Tank Size jOOO gallons Exact length of each trench
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of:
(Trench bottoms shall be level to +/-1/4"
in all directions)
Pump Requirements: ft. TDH vs. GPM
Conditions:
Aggregate Depth:
inches below pipe
inches above pipe
inches total
**If applicable: / understand the f 177 type ,rpeciTed it different from the type specified on the app/ication. / accept the fpecifwionr of t& permit
Owner/legal Representative Signature: Date:
This Construction AnthAMAhon is Ufhwt m m !f A. „i,,, .,i- . L. - . .
r uuwnuum man nos oe iransterrea when there is a change in ownership of the site. This
Construction Authorization is subject to compliance with the provisions of the aws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent- z DTI Date: 1V /3 - /0
Construction Authorization Expiration Date: fD - 1,3 - ~ 0 45-
feet Trench Spacing: Feet on Center
Soil Cover: inches
inches (Maximum soil cover shall not exceed
36" above the trench bottom)
HTE# 11C - °k5-), , Permit # 1Z ht 9
Harnett County Department of Public Health
Site Sketch
PROPERTY LOCATON: G/r! (/ZI
ISSUED T0: SUBDIVISION LOT #
Authorized State Agent: we _ Date:
~ C
i
Department of Environment, Health and Natural Resources Sheaf:
Division of Environmental Health Property ID:
On-Site Wastewater Section Lot a:
File
SOMME EVALUATION Code:
for ON-SITE WASTEWATER SYSTE W
Owner Applicant
l~ I I ~~z
Date Evahlated:
Proposed F ty- DeMp Flow (.1949r Property Size:
Location s Propuly
water Suppt~r l!c 1 didual ❑ Well ❑ Spring ❑ other
Evaluation Metlod: Auger Boring ❑ Pit Cut
Type of Wastewater: Sewage ❑ Industrial Process H
Mixed
P
R
0
P
t
1940
OIL MOAFHOLOOY
.1941
TM
PROFtId FACTOA3
L
9
it
LardM"
Paeidaal
Slope %
Horhm
DV*
00
.1941
Stuamw
Torun
.1941
ConfdoM
Mln nb
1941
soil
webmw
Color
143
soil
DiVA IN
.1956
SWO
Claw
.1944
Raw
Hails.
Pfem
CIO
A LIAR
Vx 7 Z
12
Mar Factors (.1946k
Site Classification (.1948
Evehated By:
Others PMV&