IPACHTE#Harnett County Department of Public Health
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
ISSUED T ' Do PROPERTY LOCATION: NC.ay1
25478
0. u~L~s octr`~ AtVcpuM SUBDIVISION LOT # NEW'tK REPAIR ❑ EXPANSION~❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: Me,v • t-Za.n6 'n-Zp•
Proposed Wastewater System Type: C-rircyr -rc t amt P%L
Projected Daily flow: 3 d GPD
Number of bedrooms: 3 Number of Occupants: C=, max
Basement ❑Yes No
Pump Required: ❑Yes XNo ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community "ti< Public ❑ Well Distance from well 1O O feet
Permit conditions:
Permit valid for
Five years
❑ No expiration
Authorized State Agent.:
The issuance of this permit by the Health Department in no way guarantees nce
site is subject to revocation if the site plan, pla4 or the intended use changes. The Im
the Laws and Rules for Sewage Treatment and Disposal and to conditions of this permit..
Date: 5-_I I a'l SEE ATTACHED SITE SKETCH
of other permits. The permit holder is responsible for checking with appropriate governing bodies in meeting their requirements. This
cement Permit shall not be affected by a change in ownership of the site. This permit is subject to compliance with the provisions of
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: O o ur-LS16 \3 " Nli- Mp%" t: v M PROPERTY LOCATION: N < a~}
Facility Type: M ter • UL x-2 0'J New
Basement? ❑ Yes No Basement Fixtures? ❑ Yes
Type of Wastewater System' C-0 r.rc`d r, o,L-
(See note below, if applicable
SUBDIVISION
❑ Expansion ❑ Repair
'9 No
216 Rt-0v~tc~,Js'rEM (Repair)
Installation Requirements/Conditions Number of trenches t
Septic Tank Size 1oc> co gallons Exact length of each trench I SO feet
Pump Tank Size gallons Trenches shali be installed on contour at a
Maximum Trench Depth of: '--11`1 inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
Pump Requirements: ft. TDH vs. GPM
Conditions:
LOT # ~A
(Initial) Wastewater Flow: O GPD
Trench Spacing: ~1 Feet on Center
Soil Cover: 17. inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
6 inches below pipe
Aggregate Depth: inches above pipe
f inches total
*If applicable: /understand the system type specified is different from the type specified on the app/nation. /accept the specifications of thii permit.
Owner/legal Representative Signature: Date:
This Cnnstmrtinn dnrhnrivatinn it -hi-t t,, , ;r .ti.. .,i... _i_.
r'°••• r•°~ ~~~a~~Kco. nic wn>u uumn nuommauun snap not oe transrerrea when mere is a change in ownership of the site. This
Construction Authorization is subject to compliat`ce wi `evis[ons 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: dy
Co struction Authorization Expiration Date: S• K` l
HTE# Permit # ISLO'~
Harnett County Depailment of Public Health
Site sketch
ISSUED TO:
Authorized State Agent:
13j/'
PROPERTY LOCATON: NLai
_ SUBDIVISION LOT # \ A
%-4a Sov~[s p a (t~> Date: 5' 0 'A
575 VIA
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Division of Environmental Health Property (iL..
On-site Wastewater Section Lot #
File
SOILSITE EVALUATION Code:
for ON-SITE WASTEWATER SYSTEM
Owner: Applicant:
Address:
Proposed Facility: 3 tat i Wr "cc.,C Design Flow (.1949):
Location of Site:
Water Supply: XPublic individual (j Wep
Evaluation Method: Auger Boring (j pit
Type of Wastewater /!Sewage (j Industrial Process
P
R
o SOIL MORPH
Date Evaluated: 5~ iy~CF~
Property Size:
Property Recorded:
(1 Spring [ j Other
( ) Cut
(j Mixed
F
O
LOGY
OTHER
9
•1941
PROFILE FACTORS
1
.1
40
.1942
L
E
Landscape
Po* t W
Horizon
Depth
.1941
Shuct"
.1941
CcnsWen"
So# .1943 958,
..1944
~
S Sir
IN.)
Tsxhrrs
Mineral
W*bWlw
~ SoN; : Srr~'
1 Resflr Clau
►
~5
G-a~
~
ogy
~
Coll"
IN.) Clams
Hoft d LTAR
5
v~~, r.,
fi
S$
K
C,Z
~q, ss
t{
xy
(
~
-5
C
3
G 5
4 rL 1>S
Description
Initial S stem
R paIr System
Other Factors (.1946):
lvailable Space (.1945)
Site Classification (.1948): S
iystem Type(s)
Cos-r
5dl.
Evaluated By: (3--~
Ite LTAR
Others Present: