IPAC RHTE# ~8 SM -PI33bil, Harnett County Department of Public Health 2 3 5 9 3
Improvement Permit
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PROPERTY LOCATION: 2
ISSUED TO: ~-~'1 ViAd)
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SUBDIVISION Q9~J l c7
S LOT # 7 ~
NEW`S REPAIR El
EXPANSION 1:1
Site Improvements
required prior to Construction Authorization Issuance: T
Type of Structure: 57
3 a CL
Proposed Wastewater System Type:
2f / d-4~~ S
Projected Daily Flow:
GPD
Number of bedrooms:
Number of Occupants:
max
Basement ❑Yes $Z No
Pump Required: ❑Yes ❑ No
'May be required based on
final location and elevations of facilities
Type of Water Supply: ❑ Commu
111
&
nity 5~ Publi ❑ Well
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~
Distance from well feet
/
-
Permit valid for. E'Five years
Perms conditions:
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El No expiration
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or
12, , ",V A 4, d r . e"12q 19 3 v ~ 1. r., ~
Authorized State Agent: Date: 2 - 9 - SEE ATTACHED SITE SKETCH
The issuance of this permit by th Health 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 s ject 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
Reouired 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 accords a with the attached system layout.
ISSUED TO: ~Vi.nGS~ /_JI PROPERTY LOCATION: /JZJ
SUBDIVISION A?J% 00AJ LOT # .2
facility Type:' 60 New ❑ Expansion ❑ Repair
Basement? ❑ Yes K No Basement Fixtures? ❑ Yes 6L-40
Type of Wastewater System" 2 j 1, - (Initial) Wastewater Flow: GPD
(See note below if a licable
A building permit cannot be issued with only an Improvement Permit
PP
f -4 fi~" J (Repair)
Installation RMuirements/Conditions A-4- el'Ad.
Septic Tank Size [C50,> gallons
Pump Tank Size gallons
Pump Requirements: ft. TDH vs.
Exact length of each trench J;)-
Trenches shall be installed on contour at a
Maximum Trench Depth of: __.12_
(Trench bottoms shall be level to +/-1/4"
in all directions)
GPM
€A t^
feet Trench Spacing: Feet on Center
Soil Cover inches
inches (Maximum soil cover shall not exceed
36" above the trench bottom)
Conditions:
inches below pipe
Aggregate Depth: inches above pipe
inches total
**If applicable: / understand the system type specified is different from the type specified on the application. / accept the specircations of this permit
Owner/Legal Representative Signature: Date:
stns looSlruQlon Authorization is subject to revocation it 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: ~/t~ Date: 02- 09- J 5 . a"- Construction Authorization Expiration Date:0 2- 2 F -e Po
HTE# ~ J Q 133 6 IC Permit # 23 T 3
Harnett County Department of llablic Health
Site Sketch
44, PROPERTY LOCATON: /421'
ISSUED TO: 0AVr~eJI c( SUBDIVISION )P i LOT #
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Division of Environmental Health Property ID: i
On-site Wastewater Section Lot
File
SOIL/SITE EVALUATION Code:
for ON-SITE WASTEWATER SYSTEM
Owner: o o- 3 Applicant:
Address: n Date Evaluated:
Proposed Facility: G / Design Flow (.1949): 3~ Property Size:
Location of Site: ' 2I Property Recorded:
Water Supply: ~ublic Individual Well [ ] Spring Other
Evaluation Method: ts ger Boring Pit [ ] Cut
Type of Wastewater: w age [ ]Industrial Process [ J Mixed
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SOIL MORPHOLOGY
.1941
' , OTHER
PROFILI=FACTORS-' .
1
L
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#
1940
Landscape
Position/ .
Slope%
Horizon
Depth
(IN.)
1941
Structure!-
Texture
1941'
Consistence
t.. ` Mineral ogy
`s Soit
Wetness!
Color
i 1J43
' y Soil'
Depth'(IN.)
.1956
5aprat
Class
:1944'•
Restr' ;
Profile
Class
s
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Description
Initial System
Repair System
Available Space (.1945)
System Type(s)
Site LTAR
t
Other Factors (.1946):
Site Classification (.1948):
Evaluated By0 Lh_
Others Present: