IPACHTE# 10 -s-y~ Harnett County Department of Public Health
Improvement Permit 2 6 2 8 9
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: Kc.e Irv
ISSUED TO: KG.cv Ns✓~ N C -\J t'-% m N VA G S SUBDIVISION S u tr, r" LOT # tall
NEW)( REPAIR ❑ EX SION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: SGC~ ~~U~"53
Proposed Wastewater System Type: '45 lc 9-r-oULns 0 sv his se.K,
Projected Daily Flow: 3 GCD GPD
Number of bedrooms: 3 Number of Occupants: max
Basement ❑Yes ',I<, No
Pump Required: ❑Yes X No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community K Public ❑ Well Distance from well l b O feet Permit valid for. ",14 Five years
Permit conditions: ❑ No expiration
Authorized State Agent:: Cts--\-~' 5 Date: to s5 ] 16 SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the iss 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, .1952, .1954, .1955, .1956, .1957, .1956. 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: KEN t-4 e;e~'A C -V ter, N N 6 5 PROPERTY LOCATION: ALP NN e
SUBDIVISION S v mm \ LOT #
Facility Type: New ❑ Expansion ❑ Repair
Basement? ❑ Yes X, No Basement Fixtures? ❑ Yes X No
Type of Wastewater System" 0 5~ S0t.t Sy~:Esr (Initial) Wastewater Flow: 3LU GPD
(See note below, if applicable')
0
1Zeovc..•nt.r c,) -)`5 ,e4e% (Repair)
Installation Requirements/Conditions
Number of trenches 3
Septic Tank Size o gallons
Exact length of each trench SO feet
Pump Tank Size gallons
Trenches shall be installed on contour at a
Maximum Trench Depth of. ay-3~ inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
Pump Requirements: ft. TDH vs.
GPM
Conditions:
Trench Spacing: cl Feet on Center
Soil Cover. \ a 1~1 inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
Aggregate Depth:
inches below pipe
inches above pipe
inches total
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: / understand the ryrtem type rpeciled it dih`erent from the type speciled on the application. / accept the rpeci6cationr of this permit.
Owner/Legal Representative Signature: Date:
This Construction Authorization is subject to re f the site n, 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 wi the o laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent:
(ZExs Date: 101 ts) e,
Authorization Expiration Date: o l S )5
HTE# ` S' aS3~ `1 Permit # r,(
ISSUED TO:
Authorized State Agent
narnett County Department of Public health
Site Sketch
PROPERTY LOCATON: NLe a la
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(°~~vEn -roLxs Date:
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Department of EmAronmad, Health and Natural Resources Sheet:
Division of EiMronmental Health Property ID:
On Site Wastewater Section Lot a:
File *
SOEUSITZ &VALUATION Code:
for ON-SITE WASTEWATIES SYSTEM
Owner. Applicant:
Addresic Date Bvahta<ed:
proposed Fxi tY' 3 Qe-' , aM Deslgtt Pow (.1949}: 364 Property Size:
Locatfon of Sits; Fraper~► I?teoorded
Waters Snpp[j;Pubt#t ❑ IMdividuai ❑ Well ❑ Spring ❑ Other
EvaluatiGn Methock Auger Boring ❑ Pit ❑ Cut
Type of Wastewater: ~jSewap ❑ Industrial Process Mixed
P
R
O
F
1
1940
OIL MORPHOLOOY
.1941
rm
PROFILE FAC"i(7R3
L
9
M
Laa+ omm
Poaidod
910" x
Haizos
Dep14 .1941 .1941
00 Str"t" Co wdem
Temm Minrrala
1941
SON
wetneaat
Color
.1043
soil
1N.
.1956
Sapm
Clan
.1944
Re*
Harts.
Flom
CIIN
L1'A>t
G
C V
.
Dacrlpdaa
Available s as .194!
9 rter~ a
Site LT;1A
WW Repair 4st m Mar Factors (.1946)
9 r►ta1 site ClL"Madon (J 940 ~
Evaluated By. Cry
a,s'/~
as
3 x