IPACHTE# Harnett County Department of Public Health 2 5 6 7 8
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: S-, PQy'
ISSUED T0: ~F*5sN-SS~Ur+E SUBDIVISION
LOT #
NEW)< REPAIR ❑ EXPANSION 0 Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: MP" ~ot~ ~DJ'A-tZ
Proposed Wastewater System Type: a /a R60 ~c~s s d N
Projected Daily Flow: GPD
Number of bedrooms: 3 Number of Occupants: max
Basement ❑Yes XNo
Pump Required: ❑Yes ❑ No May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community Public ❑ Well Distance from well ~ b O feet Permit valid for. Five years
Permit conditions: ❑ No expiration
Authorized State Agent:: \ • -)A5 Date: 109 SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the isn 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 Improv nt 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: PssC,r', \.J 0E PROPERTY LOCATION: Sz 0c,`f-NP" e9
1 SUBDIVISION LOT #
Facility Type: f`~ An 1Ar~, mE Cad ~ 10 1 ~ New ❑ Expansion ❑ Repair
Basement? ❑ Yes A No Basement Fixtures? ❑ Yes No
Type of Wastewater System** 2.5°!a RLsw t n t a (Initial) Wastewater Flow: 3~ O GPD
(See note below, if applicable
Quo \J P'5 t tj TA (Repair)
Installation Requirements/Conditions Number of trenches
Septic Tank Size gallons Exact length of each trench feet
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of. `3~ - Rb inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
Pump Requirements: ft. TDH vs. GPM
Trench Spacing: Feet on Center
Soil Cover: 1a--b inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
Aggregate Depth:
ConditionsN~. r.1-sN~ T`lo}c l0 affFJ~ssF~"c- 5ys:~t~. lea ~~L,-s,Es r`1~y
inches below pipe
inches above pipe
inches total
**If applicable: l understand the system type specified is dih`erent from the type specified on the application. / accept the specifications of this permit.
Owner/Legal Representative Signature: Date:
This Construction Authorization is subject cation 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 tw10 ns of the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
N. e
Authorized State Agent: FZ6~S Date:
struction Authorization Expiration Date: 9
HTE# O$ Permit # a.5~-1
Harnett (county Department of Public Health
Site Sketch.
PROPERTY LOCATON: s`socx~? Rp
ISSUED TO:~ AsoK ~C-«~ F SUBDIVISION LOT #
Authorized State Agent:
C-4.55
't o'-4fi5
Date: a3 f (Z)
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Division of Environmental Health
On-site Wastewater Section
SOILiSITE EVALUATION
for ON-SITE WASTEWATER SYSTEM
Owner:
Address:
Proposed Facility:
Design Flow (1949):
Location of Site:
Water Supply:
[ ] Public
Individual
Evaluation Method:
[ ] Auger Boring
Type of Wastewater:
[ I Sewage
P
R
o
SOIL MORPHOLOGY
F
.1941
1
.1940
L
Landscape
Horizon
.1941
.1941
E
Position/
Depth
Structure/
Consistence
#
Slope%
IN.)
Texture
Mineralogy
L5
0
10-Ll Ge2`i~- G ~cL s k
~0 G rr2 5 ~ t
Description
Available Space (.1945
'System Type(s)
Site LTAR
Initial System Repair System
JI ICdI.
Property ID:
Lot
File
Code:
Applicant:
Date Evaluated:
Property Size:
Property Recorded:
[ 1 Well [ ] Spring
[ J Pit [ J Cut
(J Industrial Process (J Mixed
[ ] Other
OTHER
PROFILE FACTORS
.1942
SoN 1943 .1956
; .19"
Profile
Wetnessr SON Saps'
S Restr
Class
Color Depth IN:) Class
Horiz
& LTAR
10`~ -t b 3-)'
P~
.3
So ]CL`t )-e 31S
Other Factors (.1946):
Site Classification (.1948):
Evaluated By:
Others Present:
.3
~S
.3