IPACHTE# III S Li )3 Harnett County Department of Public Health 29523
Imarovement Permit
A building permit cannot be issued with only an Improvement Permit
�^�� PROPERTY LOCATION:
ISSUED T0: (✓L`� f �cY �5 -(�D SUBDIVISION — LOT # C
NEWWW>< RREEPAIR�� EAPANSIQN ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: S S 61'
Proposed Wastewater System T pe: — 0 576
VnNv's �/W1
Projected Daily Flow: 3 IZ5 a5GPD
Number of bedrooms:�mber of Occupants: max
Basement []Yes ><No
Pump Required: []Yes ❑ No XMay be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community Xti, Public ❑ Well Distance from well feet Permit valid for.
Permit conditions:
five years
❑ No expiration
'�� �� J 5
Authorized State Agent: Date: � SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the issuance o r Permits. The permit holder rs responi le 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 installation requirements of Rules .1950, .1952, .1954, .1955, .1956, .1951, .1958. and .1959 am incorporated by references into this permit and shall be met Systems shall be installed in accordance
with the attached system layout.
ISSUED T0: —C,-";
HTE# �' S_Lj lam% Permit # oZ�5a3
Harnett County Department of Public Health
Site Sketch
PROPERTY LOCATON: N Lal D 5
ISSUED TO: P5 4 C=A,4; . Cd SUBDIVISION l LOT # G
Authorized State Agent: ILN-'6qSOvfSa4Q7 Date:
VC,a10
J
Department of Environment, Health and Natural Resources
Division of Environmental Health
On -Site Wastewater Section
SOIUSITE EVALUATION
for ON-SITE WASTEWATER SYSTEM
Owner: Applicant:
Address: Date Evaluated:
Proposed Facility:$r?CTiI. Design Flow(. 1 949):'l O�C'V
Location of Site: Property Recorded:
Water Supply: ublic❑ Individual ❑ Well
Evaluation Method Aug onng ❑ Pit ❑ Cut
Type of Wastewater: `sewage ❑ Industrial Process
Sheet:
Property ID:
Lot #:
File #:
Code:
Property Size:
❑ Spring
❑ Mixed
❑ Other
P
R
O
F
1
.1940
SOI, MORPHOLOGY
.1941
OTTIER
PROFILE FACTORS
L
E
#
Landscape
Position/
Slope %
Horizon
Depth
(In.)
.1941
Structure/
Texture
.1941
Consistence
Mmeralou
.1942
Soil
Wetness/
Color
.1943
Soil
IN.
.1956
Swo
Class
.1944
Resp
Honz
Profile
Clans
& LTAR
�o
s�,x�
�no1P
to-)a��Q78
u5
PS
36
G
l �
ate;
� �
v�L �1•P
C
PS:i
Description Initial Repa' System Other Factors(. 1946):
S st Site Classification (.1948): e5
Available S ce .1945Ij_ Evaluated By:
System T s dr Ur' Others Present:
Site LTAR