IPAC RHTE# CAF-J= ;0a3c`Qk Harnett County Department of Public Health 2 5 6 4 5
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: C am, f % , (,=•na 4. X&
ISSUED TO: ~6r~t -°I t`►a~.tl~~nc, SUBDIVISION F%rl-r'+ 7-,' .Lr LOT # /0
NEW P' REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: Fm ('5 ~ '(qE '
Proposed Wastewater System Type: J-S9Q,L-&t9-f: tjs -Jf-A- .
Projected Daily Flow: GPD
Number of bedrooms: Number of Occupants: max
Basement ❑Yes E~ "No
Pump Required: ❑Yes E41o ❑ MMa!",,~ - required based on final location and elevations of facilities
Type of Water Supply: ❑ Community t~" Public ❑ Well Distance from well feet Permit valid for. wive years
Permit conditions: ❑ No expiration
Authorized State Agent:: - Date: Z-a 1i271aoO SEE ATTACHED SITE SKETCH
The issuance of this permit by the liDepartment 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 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, .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: C a n•~? v, 4'30,-C! .~c. PROPERTY LOCATION: L
SUBDIVISION jC~ -f TVN~ (J- LOT # /o
Facility Type: Jlc f [t' New ❑ Expansion ❑ Repair
Basement? ❑ Yes ❑ No Basement Fixtures? ❑ Yes No
Type of Wastewater System** G~-& it,. , 1 ~iL, (Initial) Wastewater Flow: ~V C GPD
(See note below, if applicable
yZSfo r,ec1~SC~ `°r~ f✓t~cr,- (Repair)
Installation Requirements/Conditions Number of trenches
Septic Tank Size Q gallons Exact length of each trench -213 Q
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of. tR0
(Trench bottoms shall be level to +/-1/4"
in all directions)
Pump Requirements: ft. TDH vs. GPM
feet Trench Spacing: 9 Feet on Center
Soil Cover F / V inches
inches (Maximum soil cover shall not exceed
36" above the trench bottom)
Conditions: j Ii -tti- cs. CQiJ,,~ . ~
inches below pipe
Depth: inches above pipe
inches total
6 il...-_
**If applicable: / understand the system type specified is different from the type specified on the application. l accept the specircationr of thin 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
(onstrucuon Authorization is subject to com a with the provisions of the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
7- 11 , Ak5 Authorized State Agee 4 Date: /F7 20
Construction Authorization Expiration Date: CO 1,2-7 1.2 o/~
HTE # QY - 3 = Zc~ C~ /,7, Permit # c2 5- ( qr
narnett County Depa lment of IlUblic Health
Site ketch
PROPERTY LOCATON:
ISSUED TO: Co w _ -'Alc SUBDIVISION a s`E (rc,..{r LOT # /0 9
Authorized State Agent: Date: 1400
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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):
~ublic [ J Individual
[ Auger Boring
[(1 Sewage
Property ID:
Lot n
File
Code:
Applicant:
Date Evaluated:
Property Size:
Property Recorded:
[ j Well [ J Spring [ j Other
[ ] Pit [ ] Cut
[ ] Industrial Process [ J Mixed
R
R
O
F
SOIL MORPHOLOGY
.1941
OTHER
PROFILE FACTORS
L
E
#
1940
Landscape
Position/
Slope%
Horizon
Depth
(IN.)
1941
Structure/
Texture
1941
Consistence
Mineralogy
.1942. _
Soil :
Wetnesst
Color
1943 ,
_`2 Soil
Depth, (IN.}
.1956
Sapro"
Class
,1944"
- Restr:
= Horiz
Profile
Class_
<AR
7"
o
Description Initial System Repair System
Available Space (.1945)
System Type(s)
Site LTAR
Other Factors (.1946):
Site Classification (.1948):
Evaluated By:
Others Present: