IPAC RHTE#DJ- sbo-- 2079 tZ Harnett County Department of Public Health 2 5 5 2 0
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
w~vPROPERTY LOCATION: X-1
ISSUED TO: _ o. l r~ - SUBDIVISION --T"ev 01, LOT # 92
NEW JREPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: 5 C L49 04Wt?c
Proposed Wastewater System Type: ~An -f, I¢~~_E 9 Shy
Projected Daily Flow: 'PD
Number of bedrooms: wstt Number of Occupants: max
Basement ❑Yes '6} No
Pump Required-OYes ❑ No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community ~i4 ublic ❑ Well Distance from well f J~> feet Permit valid for. Five years
Permit conditions c r (ce \ T Sk%p ❑ No expiration
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State A~gent._-
Authorized 1 f Date: 3- 22 - Q .0 S ~ SEE ATTACHED SITE SKETCH _A41 C The issuance of this permit by the Ne Department 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, .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 T0: Qe~,Rn Qn}A - PROPERTY LOCATION: C `7
SUBDIVISION n LOT # E2-
Facility Type: New ❑ Expansion ❑ Repair
Basement? ❑ Yes ~4- No asement Fixtures? ❑ Yes C)r No
Type of Wastewater System"' _ t-r --r, f (Initial) Wastewater Flow:3~) A,a,<GPD
(See note below, if applicable 4A
~k ' (Repair)
Installation Requirements/Conditions Number of trenches
Septic Tank Size DZ~3 gallons Exact length of each trench 30 Z), feet Trench Spacing: Feet on Center
Pump Tank Size [ OJ gallons Trenches shall be installed on contour at a Soil Cover: 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)
Pump Requirements: ft. TDN vs. GPM
Conditions:
inches below pipe
Aggregate Depth: inches above pipe
inches total
**If applicable: / understand the system type specibed /s different from the type specified on the app/ication. / accept the rpecircationr 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 Agent: I7 Date: 3 `da- &P Io
Construction Authorization Expiration Date: 0 ~'~11- RDI
HTE# Permit #
Harnett County- Deptu-tinent of 1"liblic Health
Site Sketch
p PROPERTY LOCATON: -7
ISSUED TO: 46 9,,A SUBDIVISION `TN IN- Oti LOT # ka--
Authorized State Agent: ' ` ff Date:
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Division of Environmental Health Property ID:
On-site Wastewater Section Lot
File
SOIL/SITE EVALUATION Code:
for ON-SITE WASTEWATER SYSTEM
Owner: 0,~ J
Applicant:
Address: Date Evaluated:
Proposed Facility: S~ Design Flow (.1949): Property Size:
Location of Site: Property Recorded:
Water Supply: Public Individual Well [ J Spring [ j Other
Evaluation Method: Auger Boring [ ]Pit [ ] Cut
Type of Wastewater: ( ewage Industrial Process [ J Mixed
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o SOIL MORPHOLOGY OTHER
F .1941 Y; PROFILE FACTORS
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Structure/
Texture
Consistence
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Restr.
Class;-.
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Color,
Depth (IN.
) Class
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Description
Initial System
Repair System
Available Space (.1945)
System Type(s)
.Site LTAR
3
Other Factors (.1946):
Site Classification (.1948):
Evaluated By:
Others Present:
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