IPACHTE# 0/-,5--aik- 8 22 Harnett County Department of Public Health
Improvement Permit
A building permit cannot be issued with only an Improvement Permit j
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PROPERTY LOCATION: /
L
ISSUED TO- C1\ e
,-(i f/
pc~ 1 SUBDIVISION i.s~ m LOT #
NEW
s
T
f S
REPAIR ❑
i M
f
EXPANSION ❑ Site Improvements required prior
j
to Construction Authorization Issuance:
ype o
tructure:
v
c
Proposed Wastewater System Type:
L'& /'0_
Projected Daily Flow:
-740
GPD
Number of bedrooms:
.:1
Number of Occupants: max
Basement ❑Yes
9 No
Pump Required: ❑Yes
Cg/G
❑ May be required based on final location and elevations of facilities
Type of Water Supply:
❑ Community
IJ91"'Public ❑ Well Distance from well feet
Permit valid for: O'F`ive years
Permit conditions:
❑ No expiration
Authorized State Agent:: ti'& Date: ~ / 712-0"1 -a--'~--- ~ SEE ATTACHED SITE SKETCH
The issuance of this permit by t~ ealth Department in no way guarantees the issuance 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 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 are incorporated by references into this permit and shall be met. Systems shall be installed in accordance
with the attached system layout. J
ISSUED T0: C,-r~ C" 1 4.t PROPERTY LOCATIO'NS- C-~ C k Ck4' .A_4f_
SUBDIVISIO ~-T~.~.~ n ~
LOT #
Facility Type: f'VV /f 14 9 New ❑ Expansion ❑ Repair
Basement? ❑ Yes 12"' No Basement Fixtures? Yes ❑ No
Type of Wastewater System** (Initial) Wastewater flow: > (S GPD
(See note below, if applicable
lCa(Repair)
Installation Requirements/Conditions Number of trenches 12,
Septic Tank Size C gallons Exact length of each trench 90 feet Trench Spacing: q Feet on Center
Pump Tank Size gallons Trenches shall be installed on contour at a Soil Cover: 6-/Z- inches
Maximum Trench Depth of: / 8- !-q 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
Conditions:
inches below pipe
Aggregate Depth: inches above pipe
inches total
WATER LINES (INCLUDING IRRIGATION) MUST BE LOFT. FROM ANY PART OF SEPTIC SYSTEM OR REPAIR AREA.
NO UTILITIES ALLOWED IN INITIAL OR REPAIR DRAIN FIELD AREA.
**If applicable: /understand the system type specified is different from the type specified on the application. / accept the specifications 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 change in ownership of the site. This
Construction Authorization is subject to compliance with the provisions of the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent- ~ ,r.,.... o_
cf/
Date: r-
Construction Authorization Expiration Date: r. f ` A- 6
HTE# 5- dUb?)
Permit #
r
c- k,, U. ~
Dgmftent of Environment, Health and Natural Rescmus
Divisioa of Environmental Health Shed:
On-Site Wastewater smdon Property ID:
Lot
SOILJSITE EVALUATION File 0:
for ON-SITE WASTEWATERSYSTEM Code:
Owner. Applicant;
Address: Date Evacuated:
pnvwd Fac~ty: Design Flow (.1949}: Pmlxity Size:
Lacadott Site: propedY Recorded:
WatetsuppEy L~J, de, ❑ hxNdtW ❑ Wen ❑ Song
Evaluadon M ,L~~,~uger Boring ❑ P ft
,
Type d Wastewater. Sewage ❑ Industrial Process mIIt
P
R
O
F SOIL MUMMY
R
1 .1940 .1941 FROM L Lip Meeizoa b71.B FACTC
9 Posidew Depth .1941 1941 •1941
N SIMM % (IMA Son .1443
G -2-c
.Zt -
amucum
To
Condkeaee
Mlaerslo
Elz f
we4and
t
❑ Other
.1916 ,194 rmms
Cow Re* am
Hobs. ALtAR'
.4 J
s5'
~-J-
Site CIUMCSdon 1948);19)
s Evelueted By-4,,,-
Men Present: