IPACH T E # o$- '-x1-5 51, Harnett County Department of Public Health 2 5 6 7 7
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: SToc. G ~10MJ Qp
ISSUED TO: J '50 v ~~'Sµyty£ SUBDIVISION LOT #
NEW, REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: r*) P" I loor,F
Proposed Wastewater System Type: a5°1 a R=ovc,-s w.tJ
Projected Daily flow: 3 6 CJ GPD
Number of bedrooms:Number of Occupants: max
Basement ❑Yes No
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 O feet Permit valid for. Five years
Permit conditions: ❑ No expiration
Authorized State Agent:: 1VCK5
Date: Z5 Cl SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the ance of other permits. The permit holder is res Bible 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 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, .1957, .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: -3-e's0 'r, N E PROPERTY LOCATION: S-% 5c; yp,cZo Rfl
SUBDIVISION LOT #
Facility Type: I" 1 !N ~ A a mz- bal Iq X New ❑ Expansion ❑ Repair
Basement? ❑ Yes `~Ii4 No Basement Fixtures? ❑ Yes `X No
Type of Wastewater System** 2ks °I VFAu C/--~ s o r4 S y 5-< (Initial) Wastewater Flow: 3~ 6 GPD
(See note below, if applicable
3-S"/o 'PlCoy yS \`7 ,3 Sys ism (Repair)
Installation Requirements/Conditions Number of trenches -3
Septic Tank Size lpc~ 4 gallons Exact length of each trench lbb feet
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of. 3a-1`g inches
Pump Requirements: h. TON vs.
(Trench bottoms shall be level to +/-1/4"
in all directions)
GPM
Trench Spacing: Feet on Center
Soil Cover 2,0 --G inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
inches below pipe
Aate Depth: inches above pipe
Conditions: _~tk+ta i-~ E Tn os-. 2 lJ o q-rr SAPS gys t,r~ Q T LAS t C 5
egpy y inches total
**If applicable: / andeatand the system type specified is different from the type specified on the app/ication. / accept the specifications of this permit
Owner/Legal Representative Signature: Date:
This Construction Authorization is subject to revocauo site pla , t or the intended use chan~Th struction Authorization shall not be transferred when there is a change in ownership of the site. This
Construction Authorization is to compliance wi he the s and Rules for Sewaand Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent: Date: S
Constru n Authorization Expiration Date:
HTE# - S`a-1 3 S`,'~,- Permit #
narnett county Depa l nent of Miblic nealth
Site Sketch
PROPERTY LOCATON: CZTSOC,,~Na Zz 9,.v
ISSUED T0: SUBDIVISION LOT #
Authorized State Agenx ~EHS ll~L,vF1L io~x~pc,~ Date: '2A
`~Od
260U<.-Y~CiN I
A CL J
C1 do' S : c~ c'~-y»2D ~
ueparunenl ul CIIVIIUIIIIICIiI, r'11Cd1Ul, d11U 14dlUldl MUZUU1l CJ J1.CC/.
Division of Environmental Health Property ID:
On-site Wastewater Section Lot #
File
SOILiSITE EVALUATION Code:
for ON-SITE WASTEWATER SYSTEM
Owner:
Address:
Proposed Facility:
Location of Site:
Water Supply:
Evaluation Method:
Type of Wastewater:
Design Flow (.1949):
(j Public Individual
Auger Boring
Sewage
Applicant:
Date Evaluated:
Property Size:
Property Recorded:
Well [ j Spring Other
(j Pit [ j Cut
Industrial Process Mixed
P
R
o
F
9
SOIL MORPHOLOGY
•1941
OTHER
PROFILE FACTORS
1
L
E
.1
40
Landscape
Position/
Slope%
Horizon
Depth
IN.)
1941
Structure/
Texture
.1941
Consistence
Mineralogy
.1942
Soil
Wetness/'
Color
.1943
SON
Depth K.)
-Ow
SaPr*
Class
.1944'
f Restr
Horst
Profile ;
Class
3 LTAR
°
~u
cra
. 3
y
-lo ^
c SL
lvF
P-Ll
s$~ G
-3
Wn- r.6 1
`
'
G 5 L
VFW.- gsl ~+P
X34 G
'~2 5~5~
b127IL~ sty`
e~i
-
F
T
Description
Initial System
Repair System
Other Factors (.1946):
Available Space (.1945)
Site Classification (
1948):
System Type(s)
.
Evaluated By:
Site LTAR
Others Present: