IPACt-
HTE# 08"s y3, 18 Harn-eit County Department of Public health 2 4 6 0 2
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: y0/ nl
ISSUED T0: SUBDIVISION /t7lc_rxl LOT #
NEW REPAI EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: 5-14::L7
Proposed Wastewater System Type: "
Projected Daily Flow: GPD
Number of bedrooms: Number of Occupants: (12 max
Basement ❑Yes No
Pump Required: ❑Yes ❑ No 2 JMa Kerequired based on final location and elevations of facilities
Type of Water Supply: ❑ Community ublic ❑ Well Distance from well feet Permit valid for. ❑'v
a years
Permit conditions: ❑ No expiration
Authorized State Agen : Date: SEE ATTACHED SITE SKETCH
The issuance of this permi a Health Department in no way juarantees the issuance of her permits. The permit holder is responsible for checking with appropriate governing bodies in meeting
their requirements. This site is subject to revocation H 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 la out.
ISSUED TO: T PROPERTY LOCATION: 0
~ SUBDIVISION LOT # a0?
facility Type: Z New Expansion ❑ Repair
Basement? ❑ Yes No Basement fixtures? ❑ Yes 0 No
Type of Wastewater System** a$7'4Wr)f/GiZinJ i (Initial) Wastewater flow- JW 6 GPD
(See note below, if applicable
.7~ (Repair)
InsWi tion Rquim unts/Cmtditions
Septic Tank Size DO D gallons
Pump Tank Size gallons
Pump Requirements: ft. TDH vs.
Conditions:
.3x
Exact length of each trench 10 feet
Trenches shall be installed on contour at a
Maximum Trench Depth of: -7/ inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
GPM
Trench Spacing: / feet on Center
Soil Cover. inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
Aggregate Depth
to inches below pipe
inches above pipe
_12- inches total
**If applicable: / anderizand the system type rpeciled it diherent from the type specified on the app/ication. / accept the specilcationr 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 provisions of the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit.
SEE ATTACHED SITE SKETCH
Authorized State A Date: va - r t3 - 0a
Construction Authorization Expiration Date: Z- 1 S - f
HTE# 08- S- /93h'f3 Permit # may/ o Z
Harnett County Department of hiblic Health
Site Sketch
PROPERTY LOCATON: do r,J
ISSUED T0: SUBDIVISION
en~= LOT #
Authorized State Agar Date: a2 / o - v
s3
a
\ I
30 ~z
tia
ueparunenr ut r-mmu111tICta, rlt:wm, cwu 114dtuldl mezuu1t,CJ
Division of Environmental Health
On-site Wastewater Section
Owner:
Address:
Proposed Facility:
Location of Site:
Water Supply:
Evaluation Method:
Type of Wastewater:
SOIL, SITE EVALUATION
for ON-SITE WASTEWATER SYSTEYI
Design Flow (.1949):
( Public Individual
(,~Au Boring
( Sewage
JI ICCI.
Property ID(
Lot
File
Code:
Applicant:
Wel
it
( ) indu I Process
V
/73~
Date Evaluated: L-tom'oS
Property Size:
Property Recorded:
Spring Other
[ ) Cut
( ) Mixed
P
R
o
F
SOIL MORPHOLOGY
•1941
OTHER
PROFILE FACTORS
1
L
E
#
.1940
Landscape
Position/
Slope%
Horizon
Depth
(IN.)
.1941
Structure/
Texture
.1941
Consistence
Mineralogy
.1942
Soo
Wetness/-
Color
AM .1956
SON Saps "
Depth (IN.) Class
; .1944
Restr
Horiz
Profile
Class
& LTAR
yZ
~Qtio) ~
ss~
2 ,uP
s~ Y
XL
jo- J(f
C r r
I ,S',
Ltqr*
Description
Initial Sy m
Repair System
Available Space (.1945)
System Type(s)
ISite LTAR
Other Factors (.1946):
Site Classification (.1948):
Evaluated By:
Others Present: