IPACHTE#% Harnett County Department of Public Health 29133
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: N V cL en J {�
JD
ISSUED T0: W Gum v�aP C °fL I G SUBDIVISION LOT # 1�5
NEWX REPAIR ❑ EXPON ❑
Type of Structure: S
Site Improvements required prior to Construction Authorization Issuance:
SFS C3�
Proposed Wastewater System Ty8�ee YNI e770 e�S�. � 2�!7$ .
Projected Daily Flow: L's`6 GPD
Number of bedrooms: I') Number of Occupants: _max
Basement ❑Yes �No
Pump Required:\IEqes ❑ No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: 1:1Community 'V Public ElWell Distance from well tl, Q d feet Permit valid for.Five years
Permit conditions: ❑ No expiration
Authorized State Agent.: ii�— S Date: NZ_ 3ollb SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees th_e*Rlieuuce of otter permits. The permit holder is respomib 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 nomination 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 astaked in accordance
with the attached system layout.
ISSUED TO: r-rVZ>,C7� f0i — 1�s` C. PROPERTY LOCATION: N VC1565Z7
_� N 0Qr h1 LOT # 1—Axr 5
Facility Type: 5 C l7 �3�'`2S� SUBDIVISION X New ❑ Expansion ❑ Repair
Basement? ❑ Yes 'N( No Basement Fixtures? ❑ Yes )( No
Type of Wastewater System" ?c) cop o QkC /G Pr—a o7 ,cis 5/ S ; r— (Initial) Wastewater Flow: 1• 0 GPD
(See note below, if applicable ❑) _
�yYc1P ��L� 9-0�,5u3 (Repair)
Installation Requirements/Conditions Number of trenches I
Septic Tank Size 1000 gallons Exact length of each trench 9q0 feet
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of.. I "aLj inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
Pump Requirements: ft. TDM vs. GPM
Conditions:
Trench Spacing: Feet on Center
Soil Cover. 671Dinches
(Maximum soil cover shall not exceed
36" above the trench bottom)
Aggregate Depth:
WATER LINES (INCLUDING IRRIGATION) MUST BE IOFT. 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 spedfved is different from the type spec led on the app/kation. / accept the spec/!cations of this permit
vwner7Legal isepresewauve signature: Date:
This construction Authorization is subject cation if the site plan, plat or the intended use changes. The (instruction Authorization shall not be transferred when there is a change in ownership of the site. This
construction Authorizatio ect to coma: it visions of the laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit. SEE ATTACHED SITE SKETCH
Authorized State Agent: 11,4Date: 12 3 0) 6
Construction Authorization Expiration Date: t Z 9.l
HTE# )G- 5-405 Ln
ISSUED TO:
Authorized State Agent:
Permit # a�1133
Harnett County Department of Public Health
Site Sketch
PROPERTY LOCATON: 9D
C- SUBDIVISION Si aoobn Ltx,( s LOT #
-Sp7�SD(3 Date: t2,30I��
Department of Environment, Health and Natural Resources
Division of Environmental Health Sheet:
On -Site Wastewater Section 'Property ID:
Lot #:
SOIL/SITE EVALUATION File #:
for ON-SITE WASTEWATER SVSTM Code:
E
Owner; Applicant:
Address:;,1� j
Proposed Facility.Wb Date Evaluated:
Design Flow (.1949): >�C�
Location of Site: Property Size:
Water Supply: Property Recorded:
ublic❑ Individual ❑ Well
Evaluation Method:Q�ugetB 'ng ❑ SP�B
Type of Wastewater; El ❑Cut
Sewage 13 Industrial Process ❑ Mixte
5$K
cr �(
5 V°a
tf�gx-2 7,
dLi �.. 33X `SGL r`7. 55
C 75 1 Nht
53 \e I w .b s�
Site Classification (1948):
Evaluated By:
Others Present:
) — Q
)'ter 18 C 1,2'i4
❑ Other
OTHER
ILE FACTORS
.1943 .1956
Soil
.1944 Profile
Restr I Class
P'
3
P5 5-
SOI, MORPHOLOGY
IF cape
Horizonod
1941
Depth
;1941 •1942
%
(In.)
.1941
Suucnud Soil
Consistence
r- .._ Wetness/
5$K
cr �(
5 V°a
tf�gx-2 7,
dLi �.. 33X `SGL r`7. 55
C 75 1 Nht
53 \e I w .b s�
Site Classification (1948):
Evaluated By:
Others Present:
) — Q
)'ter 18 C 1,2'i4
❑ Other
OTHER
ILE FACTORS
.1943 .1956
Soil
.1944 Profile
Restr I Class
P'
3
P5 5-