IPAC{
HTE# - - a«~- Harnett County Department of Public Health 2 5 2 7 0
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
ISSUED TO PROPERTY LOCATION: Z Jj _ l r31 w-li-J-/ .
SUBDIVISION 1 c~i c ~ c rci LOT # -/2-Z
NEW k? REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: 0 r c ys-
Proposed Wastewater System Ty e: f~ 1,4Z t
Projected Daily Flow:GPD
Number of bedrooms: Number of Occupants: max
Basement ❑Yes CNo
Pump Required: ❑Yes ❑ No 1V1MMav-6e required based on final location and elevations of facties
Type of Water Supply: ❑ Community R Public ❑ Well Distance from well 4ec feet Permit valid for,
Permit conditions:
19--Five years
❑ No expiration
Authorized State Agent:
Date: 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 revocatio , ' the site plan, plat, or the intended use change. 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, .19% 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: ~sv_w►7t~~ c1 cp
PROPERTY LOCATIO /
SUBDIVISION / z any LOT #
Facility Type: 15 r- New ❑ Expansion ❑ Repair
Basement? ❑ Yes No Basement Fi)gures? ❑ Yes ❑ No
Type of Wastewater System** -)~Y Je,JQc.1 ~rll-l (Initial) Wastewater flow: GPD
(See note below, if applicable 11
(Repair)
Installation Requirements/Conditions Number of trenches S
Septic Tank Size gallons Exact length of each trench v ` Q feet
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of: /c~- - 2 d` inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
Pump Requirements: ft. TDH vs. GPM
Conditions: -~J t~i,,t c ~ ;~'r2
Trench Spacing: Feet on (enter
Soil Cover: C /-L inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
inches below pipe
_ Aggregate Depth: inches above pipe
inches total
"*If applicable: / understand the ystem type specified is different tram the type speciFed on the application. / accept the specidcatianr 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 of the site. This
ownership
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:
C
t :J• Date:_ t;C
r Construction Authorization Expiration Date: Z ~Z 4"
HTE# ~ 9 5- ca~S- Permit # rJ- 7 c:
Harnett County Depal-trrlerlt of F' blic Health
Site Sketch
PROPERTY LOCATON; e
ISSUED T0:,v^1 SUBDIVISION L 0 T #
Authorized State Agent: l is C Date: Z
~t
1- i-ie "
ftvy
446j- s4" G
'tom b
uepannieniui cnvuuiu--,
Division of Environmental Health
On-site Wastewater Section
SOIL/SITE EVALUATION
for ON-SITE WASTEWATER SYSTEM
Owner:
Address:
Proposed Facility:
Location of Site:
Water Supply:
Evaluation Method:
Type of Wastewater:
Design Flow (.1949):
[ TPublic ( ] Individual
[,A er Boring
( Sewage
Property ID:
Lot
File
Code:
Applicant:
Date Evaluated:,//
Property Size:
Property Recorded:
[ ] Well [ ] Spring [ ] Other
[ J Pit [ ] Cut
[ J Industrial Process (J Mixed
P
R
o
F
SOIL MORPHOLOGY
.1941
OTHER
PROFILE FACTORS
(
L `
E
#
.1940
Landscape
Position)
Slope%
Horizon
Depth
IN.)
1941
Structure/
Texture
11941
Consistence
Mineralogy "
.1942:.
Soil .
Wetness/'
Color
r...1943,
Soil' ;
Depth (IN.)
.1956
Saprd
Class
1944'
t Restr,
Horiz -
Profile
Class;
& LIAR `
LS
J' Y~
C
~
C(2--t
/V'9
3
fj
(bk
&J
-'-t /
f~
~y
J~' r /JC
)r 4)
Description
Initial System
Repair System
Available Space (.1945)
/
System Type(s)
f
r ,
Site LTAR
S
Other Factors (.1946):
Site Classification (.1948): ~f
Evaluated By: 1~f
Others Present: