IPACHTE# a-) Harnetc County Department of Public 'health 2 4 51 5
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: _ T¢ uE.wvC-QZ _
ISSUED TO: sc ort EC ~Or'vC-S `^+C- SUBDIVISION ~lor.ta~apsw ~soGC LOT # _ l3_
NEWX REPAIR ❑ ExP SION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: 5FD (;n xyS "J
Proposed Wastewater System Type: CoNv~ r~.oHt~~ _
Projected Daily Flow: 3(-I O GPD
Number of bedrooms: _ 3 Number of Occupants: --max
Basement ❑Yes ~ No _
Pump Required: ❑Yes ❑ No May be required based on final location and elevations of fadlihes
Type of Water Supply: ❑ Community 1~11 Public ❑ Well Distance from well 1p0 _ feet Permit valid for. Five years
Permit conditions: ❑ No expiration
Authorized State Agent ` Date: S ` IC-1 SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarante 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 Buildine Permit
The construction and installation requirements of Rules .1950, .1952, .1954, .1955, .1956, .1957. AM. and .1959 are incorporated by references into this permit and shad be met. Systems shall be
installed in accordance with the attached system layout.
ISSUED TO: Sc o ct I- T: ~a~-.C_S PROPERTY LOCATION: -Tst vc t~vC
SUBDIVISION _'oN9(~,kft4 R.ocE LOT # 13
Facility Type: 5F0 LS~~4 S~ A New ❑ Expansion ❑ Repair
Basement? ❑ Yes No Basement Fixtures? ❑ Yes 'K No
Type of Wastewater System"" CON "&,$I 1or4 o.t-- (Initial) Wastewater Flaw:. GPD
(See note below, if applicable
[~C-E 9-w (Repair)
Instalhtion Regu'iramrtts/Coaditiions
Septic Tank Size toe)o gallons
Pump Tank Size gallons
Pump Requirements: ft. TDH vs.
Conditions:
S -taENc~+Gg
Exact length of each trench ~o O feet
Trenches shall be installed on contour at a
Maximum Trench Depth of. 3.4 - 30 inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
GPM
Trench Spacing: Feet on Center
Soil Cover i a--A`a inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
Aggregate Depth:
C, inches below pipe
a. inches above pipe
s inches total
**If applicable: l underrtand the system type specified it different from the type specified on the application, l accept the specificatiomr of thin permit.
Owner/Legal Representative Signature:
This Construction Authorization is wbject i
of the site, This Constructs horization is
Authorized State Agent:
Date:
plan, plat, or the intended use changes. The Construction Authorization shall not be transferred when there is a change in ownership
th the provisions of the taws and Rules for Sewage Treatment and Disposal and to the conditions of this permit.
SEE ATTACHED SITE SKETCH
Date: a8
Co ction Authorization Expiration Date: t tb 13
HTE# 0~ -S- `VGA Permit # `x'-151
Harnett County I eptlilinent of Miblic Health
Site Sketch
PROPERTY LOCATON: k u6LpvG 1 -0
ISSUED TO: Sca7) LC-9- `4Q~ SUBDIVISION 7Yo,•ot~,y\Nw R,or-r. LOT # i3
Authorized State Agent-~~►& Date: 61 61
d`Lvz~
Ueparuualu Ur Grvrruruuwn, nearur, d1W rv.awt{ auurl.ea '31 MVq
Division of Environmental Health Property 10:
On-site Wastewater Section Lot 4:
File
SOIL,SITE EVALUATION Code:
for Or-SITE WASTEWATER SYSTEM
Owner. AppilcanC
Address: Date Evaluated:
Proposed Factiity: 3 #ZkQ~`c%- )1 of ~ Design Flaw (.1949r 3~ 03 J P " Property Size:
Locobon of Site. Property Recorded:
water Supptr• Pubuc ( ) Individual (j well Spring
Evaluation titethod:~Auger Boring Pit Cut
Type of wastewater: sewage I) Industrial Process Mixed
I ) Other
P
R
0
F
SOIL MORPHOLOGY
1941
OTHER
PROFILE FACTORS
1
L
E
r
Ago
Landscape
Posalow
Skqe%
Hortnorr
a"*
1
.1941
sin/
Texh"
.1941
Consiob .'e
MkIerelow
.194= .
soai
weemse
Cd"
.199
Sat .
Delp* I1.)
ion
sue,
cores
`..1944`
Res~r
Hals
PtafMtfi
a LTAR •
5--7`/c
-4
Frz
Ps
Description
Inltlal System
Repair System
Available Space (.1943)
vo
System Type(s)
G c} r J
n t
Alt. 1 TAR
. L
,"i
Other Factors (.1946):
Site Classification (.1948r t'5
Evaluated By: C
Others Present: