IPACNTE# 1�'S�O^q Harnett County Department of Public Health
29130
Improvement Permit
A building permit cannot be issued with only an Improvement Permit(1
PROPERTY LOCATION: M CQ 0 UrGWZ Ro
ISSUED T0: 1�6ro 4Gns S C.tsl \M sN . SUBDIVISION LOT #
NEW'3K REPAIR ❑ MANSION ❑
Type of Structure: SVO �%5�-"Sy7
Proposed Wastewater System Type: rc)-'� Iff Rc ovct t oN S ar9,c N,
Projected Daily Flow: 3te0 GPD
Number of bedrooms:�r'3 Number of Occupants: Co max
Basement []Yes2Neo
Pump Required: ❑Yes ❑ No � a be required based on final location and elevation of fatalities
Type of Water Supply: ❑ Community Public El Well Distance from well 1O� feet
Permit conditions:
Site Improvements required prior to Construction Authorization Issuance:
Permit valid for. 'Five years
❑ No expiration
Authorized State Agent: tiv 936 -Ir 0 Date:1-1-1 IS , s ` SEE ATTACHED SITE SKETCH
The issuance of this pennit by the Health Department in no way guarantees the Hance 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 changer The Imp ement Permit shall not be affected by a change in ownership of the site. This permit is subject m 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, .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 IayouL
ISSUED TO:)Cras�s6iN CmMIN'S PROPERTY LOCATION: c0iuc,S-,LD 1ptlr)
SCp `5a x SUBDIVISION LOT #
Facility Type: 54� New ❑ Expansion ❑ Repair
Basement? ❑ Yes I�K No Basement Fixtures? ❑ Yes No
Type of Wastewater System" 2�5'l0 �CAvc.'c-' to (,rM (Initial) Wastewater Flow: GPD
(See note below, if applicable ❑)
`�jl-3 ('o Q'Cp • 5 -Y5 (Repair)
Installation Requirements/Conditions Number of trenches S
Septic Tank Size t2a0 gallons Exact length of each trench as S feet
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of: Y1D. inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
Pump Requirements: ft. TDH vs. GPM
Conditions:
Trench Spacing. Feet on Center
Soil Cover: inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
Aggregate Depth:
WATER LINES (IN(LUDING IRRIGATION) MUST BE LOFT. FROM ANY PART OF SEPTIC SYSTEM OR REPAIR AREA.
NO UTILITIES ALLOWED IN INITIAL OR REPAIR DRAIN FIELD AREA.
inches below pipe
inches above pipe
inches total
"If applicable: / understand the system type spedled is d%rent from the type spec/led on the application. l accept the rpecilcationJ of thij 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 change in ownership of the site. This
Construction Authorization is su rano with ovisions of the laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent: e&V Date: AZ I
sttuction Authorization Expiration Date: [z S
HTE# IC -S- 4�3�1 Permit # ' ` 36
ISSUED TO:
Authorized State Agent:
Harnett County Department of Public Health
Site Sketch pp�
PROPERTY LOCATON: aoC,SaLO `�
C J C- 6 SUBDIVISION LOT #
0.15 �L;J6L-ou�vf& Date: 1��1511
T
X77,
Department of Environment, Health and Natural Resources
Division of Environmental Health Sheet:
On -Site Wastewater Section -Property ID:
Lot #:
SOIUSITE EVALUATION File #:
for ON-SITE WASTEWATER SYST Code:
EM
Owner: Applicant:
Address: Date Evaluated:
Proposed Facility: -3 R>oA-1
Location of Site: - Design Flow (.1949):.36 0' (ri
Water Supply: Property Recorded: Property Size:
Evaluation Meth Public❑ Individual ❑ Well
od:7 Au erBoring ❑Pit ❑ Spring
Type of Wastewater. ❑Cut
Sewage ❑ Industrial Process ❑ Mixed
P
R
O
F
1 1940 SOI. MORPHOLOGY
L Landscape Horizon .1941 PRO
E Position/Depth .1942
# Slope % (In.) -1941
Structure/ .1941 Soil
Consistence Wdaesw
Texgae Minenlo
LS Color D,
0-16
(1 <, i
". r,\ --3 )Nr
6a�
�3xS&L
�n sA)
aA�r,
53 )t SLL
�-� 551
loy27R (. o-
) 6)i --)_, b 3a,
Site Classification (.1948):-5
Evaluated By: P_C
Others Present:
❑ Other
OTHER
FILE FACTORS
.1943 .1956
soil e,__
.1944 Profile
Restr I Class
vs
P$
. _Zs—
ID
4)