IPACHTE# IQ-S4a3Q"1 Harnett County Department of P blic Health 2 5 8 8 4
Improvement Permit J
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION:
ISSUED TO: Qst-.-t -•kci-oQ~h t~ SUBDIVISION 5y rn rn LOT #
NEWX REPAIR ❑ JXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: 5VS> ("'3'7-(31
Proposed Wastewater System Type: CoN•t~~: ko rJ tel.
Projected Daily Flow:o O GPD
Number of bedrooms: 3 Number of Occupants: max
Basement ❑Yes N No
Pump Required: ❑Yes ❑ No (X May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community Public ❑ Well Distance from well 100 feet
Permit conditions:
Permit valid for.
Five years
❑ No expiration
Authorized State Agent::
The issuance of this permit by the Health Department in no way guarantees the issuanc t
site is subject to revocation if the site plan, plat, or the intended use changes. The Improvem
the Laws and Rules for Sewage Treatment and Disposal and to conditions of this permit.
Date: a) s11 VC5 SEE ATTACHED SITE SKETCH
permits. The permit holder is responsible for checking with appropriate governing bodies in meeting their requirements. This
gmit shall not be affected by a change in ownership of the site. This permit is subject to compliance with the provisions of
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: ~JS>.vEa. OE1EL-v?, ~
Facility Type: 5Es-0() X New
Basement? ❑ Yes ';R No Basement Fixtures? ❑ Yes
Type of Wastewater System" Cc, ~4 -4 S-- -r, ~ o r t 4-,
(See note below, if applicable
Co Iv tv . V rt NL
Installation Requirements/Conditions
Septic Tank Size I O d o gallons
Pump Tank Size gallons
Pump Requirements: ft. TDH vs.
Number of trenches a
(Initial) Wastewater Flow: 340 GPD
Exact length of each trench 5 feet Trench Spacing: °I Feet on Center
Trenches shall be installed on contour at a Soil Cover: ` a inches
Maximum Trench Depth of. inches (Maximum soil cover shall not exceed
(Trench bottoms shall be level to +/-1/4" 36" above the trench bottom)
in all directions)
GPM h b I
Aggregate Depth:
Conditions: '1a~sr1- L--E- g(:r k0 'Ftwr, SEPsN11- S-15;E~
me es a ow plpe
ZI inches above pipe
_.1 'A'_ inches total
**If applicable: / andelstand the system type specified is different from the tv rpec16ed oo the app/ication. / accept the rpeciIIWionr o/ this permit.
Owner/Legal Representati Si nature: Date:
This Construction Authorization is subject to revoca e plan, 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 i compliance with th visio La and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
PROPERTY LOCATION:
SUBDIVISION oMM`~ LOT # 15
❑ Expansion ❑ Repair
X No
Authorized State Agent: ~Date: s7 110
Constructlo uthorization Expiration Date:
H T E # I C) - 5- (;Y Permit # asS%~}
Harnett County Depar(nlent of Public Health
Sitt Sketch
PROPERTY LOCATON:
ISSUED T0: ~Ea~ cc1. ~vE~Q ~E r f SUBDIVISION S M c~, LOT # `~S
Authorized State Agent: e r~S ~A 4L►~S Date: ' 1-1 C)
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D Vpott n t of EMAroomat, Health and Natwai Resowtxs Sheet:
I3ivislon Of Euvimamealal Health Property ID:
On-Site Wastewater section Lot g:
SOIL SITZ EVALUATION File
:
for ON-SITi~ WAST&WA II &A SYSTEM Code:
owns. Applicant:
Addtds: Die Evahlated: a 1
Locatiaw of Site: t)r 3 pc t.o.4 am Design Flow (.1949):34o
Piopeitp size:
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13 mvidud D weu 0 Sping
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Evabudon Method: 9Auger Boring pit cut
Type of Wamewater: Sewage ❑ 1nd6i- ocesa 8 Mbw
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