IPACHTE# t--3 IS 3C~ Harnett County Department of Public Health
Improvement Permit 2 6 2 9 3
A building permit cannot be issued with only an (rtaprovement Permit
f PROPERTY LOCATION: •C` 1 c'- c U 6JV'L1D
ISSUED TO: ► 11 nt Co S) ZU c N Le i SUBDIVISION ~u y m M es-L A t_ LOT # 1
NEWA REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: 0-in -
Proposed Wastewater System Type: cr sr~~c~ c 'JUC'vC 1
Projected Daily Flow: 3C~C? GPD
Number of bedrooms: Number of Occupants: C max
Basement ❑Yes XNo
Pump Required:'~I?Ues ❑ No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community Public ❑ Well Distance from well k 0 C1 feet Permit valid for. Five years
Permit conditions: ❑ No expiration 11 Authorized State Agent:: Q&As Date: a ( SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the issuance of`ooer permits. The permit holder is responsib for checking with appropriate governing bodies in meeting their requirements. This
site is subject to revocation d the site plan, plat, or the intended use changes. The Improvement Rermit 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, .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: \4 `fN `~i2 0 r PROPERTY LOCATION: ~A Gx") 0U FPL
SUBDIVISION S v ^nrn&A tLL LOT # _
Facility Type: S~ld_ New ❑ Expansion ❑ Repair
Basement? ❑ Yes No Basement Fixtures? ❑ Yes )K No
Type of Wastewater System' v "-"P -Q ~f ra ~C>OL1C--' L(i -N s),
>1 (Initial) Wastewater Flow: GPD
(See note below, if applicable//6 Ct~ P V m4~ 01 c-~ t 0 TJ (Repair)
Installation Requirements/Conditions Number of trenches A--
Septic Tank Size 100 0 gallons Exact length of each trench i'~g 0 feet Trench Spacing: Feet on Center
Pump Tank Size gallons Trenches shall be installed on contour at a Soil Cover inches
Maximum Trench Depth of: )il 4~ 4 Inches (Maximum soil cover shall not exceed
(Trench bottoms shall be level to +/-1/4" 36" above the trench bottom)
in all directions)
Pump Requirements: ft. TDH vs. GPM inches below pipe
Conditions:
Aggregate Depth: inches above pipe
inches total
WATER LINES (INCLUDING IRRIGATION) MUST BE ]OFT. FROM ANY PART OF SEPTI( SYSTEM OR REPAIR AREA.
NO UTILITIES ALLOWED IN INITIAL OR REPAIR DRAIN FIELD AREA.
**If applicable: l understand the system type specified is different from the type specified on the application, l accept the speci6cvlrons of this 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 chanoe in ownershin of the cite- This
Construction Authorization iCtnbje~to complia, vtth rovisons of the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent: Date: t C> a.,( ) 0
nstruction Authorization Expiration Date: 1 0 az
HTE# I C> S~~-S3Oa Permit #
Harnett County Department of M- blic Health
Site Sketch
PROPERTY LOCATON: M c,Q 0 v ~a,L~ ~sj
ISSUED TO: -y n He u, "o ".I SUBDIVISION S u crc- 64- 1~ LL LOT #
Authorized State Agent
N I
Date: 18_A'Agi)~ 6
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Department of Em immnenk Health and Natural Rm rcea
Division of Environmental Health
On-Site Wastewater Section
SOIIJSrM IIVALUATIO14
for OK-SITE WASTzWATZRSYSTI
Shed:
Property ID:
Lot N:
File ll:
Code:
Owner. Applicaa
Addtem Data Evacuated:
Proposed Facaclty: V'c- o~ c Dip Ftow (.1949y 3ko Prq" Size:
Locadoa of 9Itet Prop!ert~c~
Water super; Publ# ❑ Ldividuat ❑ Well
❑ Spring El other
Evduadon Method: Auger Boring 0 Pit cut
Type of Wdstewater: Sewage ❑ W striae Pmcess cl mbW
I
P
R
O
F
SOIL IMORPHOL00Y
OTHER
1
L
.1940
[
W
H
.1941
PRO
FACTORI
E
N
a
MP
PoridoW
310" ~
arim
DqA
00
.1941
st
d"
.1941
.1941
Suit
L
141
.1916
.1944
Ply
u
Ted
CmWd4 m
Mtnrrab
Wetrua f
Coto
soil
S"m
Re*
Ctuo
QV.
Ctar
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a LIAR
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Site C1awcadon (.19482 P 5
Evaltzbed By: 5
Othas Present 13 rn
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