IPAC RHTE#~'~g Harnett County Department of Public Health 2 5 5 0 5
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: 12
ISSUED T0: SUBDIVISION S Q c 7 o a fc LOT #
NEW -W REPAIR ❑ EXPANSIJ ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: 3 -
Proposed Wastewater System Type:
Projected Daily Flow: 3L3 GPD
Number of bedrooms: C`r ~c~yt Number of Occupants: max
Basement ❑Yes -ON o
Pump Required,, es ❑ No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community -LlTublic ❑ Well Distance fro well 100 feet Permit valid for Five years
Permit conditions: M f, f, QAJ, 1 F, rp, ( LA -to ~ ❑ No expiration
11
Authorized State Agent.: t.- Li If TYCO _ Date: 5 5- 0 12 'D 'r7 - 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 subject to revocation if a 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.
ISSUED TO: ¢ ~~ffJ PROPERTY LOCATION: !/zt'
SUBDIVISION 7 LOT # jam`}
Facility Type: h~ 3~ J 3Q f2- pin- New ❑ Expansion ❑ Repair
Basement? ❑ Yes V--No Basement Fixtures? ❑ Yes No
Type of Wastewater System** it ZT ,~c(<l~c ~r -r~ (Initial) Wastewater Flow: 3 4, ~N GPD
(See note below, if applicable VJ Q f
t "-P T- vl (Repair)
Installation Requirements/Conditions Number of trenches
Septic Tank Size DD 0 gallons Exact length of each trench feet
Pump Tank Size /o:),> gallons Trenches shall be installed on contour at a
Maximum Trench Depth of: _Jy'--2 inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
Pump Requirements: ft. TDH vs. GPM
Conditions
Trench Spacing:_ Feet on Center
Soil Cover L inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
Aggregate Depth:
inches below pipe
inches above pipe
inches total
**If applicable: / understand the system type speciled is different from the type speciled on the app/ication. / 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 (p'rovisi~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:
L^ Date: D 5` d -31
Construction Authorization Expiration Date: Cri- - 91 t 3
HTE# --~b3djdO SA Permit # 021s-b ~
Harnett County Department of Public Health
Site Sketch
PROPERTY LOCATON: / 1,2 r
ISSUED TO: Wly c SUBDIVISION ~~7 !t J LOT # -c_
Authorized State Agent: Date: Of-rq 7
W76, peg
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Olvislon of Environmental Health Property ID:
On-site Wastewater Section Lot 4
Fib #
SOILISITE EVALUATION Code:
for Or-SITE WASTEWATER SYSTEM
Owner: Applicant:
Address:
Proposed Facility: S~ Design Flow (.1949r
Loudon of Site:
water Supply: SAugsr ublic O Individual O Well
Evaluation klethad: Baring Pit
Type of Wastewater: ewe" (J Industry Process
Date Evaluated:
Property Size:
Property Recorded:
( J Spring
( ) cut
( J Mixed
( I Other
P
R
o
f
SOIL MORPHOLOGY
t941
OTHER
PROFILE FACTORS
1
L
0
•
.1940
Landscape
Pos*kmV
S %
1 kw i a
Oepik
IN.
.1941
Sbucfn W
Too"
.1941
ConslsMsrtcm
.1942
$ad
Webtese.
color
.1943
tl)
-ion
Ch"
` ..1W
Moroi
phft
I& LTAR'
711,-
CA ~
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Description
Initial System
Re air stem
Other Factors (.1948):
Available Space (.1943
Site Classification (.1048): V
System T e(s)
\ t
~t( T
Evaluated By: n /
Site LTAR
~
l
-7 f
Y
Others Present: