IPACHTE# /0 -s - 416 6(, Harnett County Department of Public Health 2 5 7 3 6
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
ISSUED TO• ,~S F~ SUBDIVISION CATION: -15-61
LOT #
NEW REPAIR ❑ EXPANSION Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: INdt/E~ A z
Proposed Wastewater System Type: COr1 vcslu. p
Projected Daily Flow: 36o GPD
Number of bedrooms: Number of Oaupants: ~_max
Basement ❑Yes [;?/No
Pump Required: ❑Yes ❑ No V May be required aced on final location and elevations of facilities /Five Type of Water Supply: ❑ Community 0 Public Well Distance from well ido feet Permit valid for. years
Permit conditions: /V D 2'5"1,- " e~"e.-4--c0--~P 6ri 11 / Z r , ~ ~ l~.Lr~tf A jr, No expiration
Authorized State Ag Date: - - SEE ATTACHED SITE SKETCH
The issuance of this permit by a Health 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, .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,/z s:A ✓Pitn~ Z27 PROPERTY LOCATION: -KIS 6/ ZTI- - ~ 124
/ SUBDIVISION LOT #
Facility Type: a v 64 C~ New , Expansion ❑ Repair
Basement? El Yes li~ No Basement Fixtures? ❑ Yes 2' No
Type of Wastewater System- C&ys ✓ U/ S ~ (Initial) Wastewater Flow: -3 4- d GPD
(See note below, if applicable 3-
if (Repair) v~l ✓
Installation Requirements/Conditions Number of trenches 3
Septic Tank Size /00 6 gallons Exact length of each trench I feet Trench Spacing: Feet on Center
Pump Tank Size / o G b gallons Trenches shall be installed on contour at a Soil Cover. H inches Aviv
Maximum Trench Depth of: 11 ' , ""'ches (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. TDH vs. GPM inches below pipe
Aggregate Depth: 2- inches above pipe
Conditions: D 57 Z `s ~'►1!1- /Z inches total
If applicable: l understand the system type rpeciled it different from the type .rpeciped on the application. / accept the specifmvianr of this permit.
Owner/Legal Representative Signature: Date:
-„u-- .a ~ uutcu io ie.uiaiwu n we am pmu, pia4 ur me mtenoeo use cnanges. me construcuon Authorization Shan not oe transterred 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 Ag r~^' Date:
Construction Authorization Expiration Date: Y - - /
HTE# Permit # of S -7 3 1,7
Harnett County Depailinent of 1'~lhlic Health
Site Skett-11
_ PROPERTY LOCATON:
ISSUED TO: SUBDIVISION LOT #
Authorized State A
Date:
is-Z / x~ 6
No
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Department of Environment, Health and Natural Resources Sheet:
Division of Enviromuental Health Property ID:
On-Site Wastewater Section Lot
File
SOIIJSTTE EVALUATION Code:
for ON-SITE WASTEWATER SYSTEM
Owner. Applicant: O X-
Address: Date Evaluated: q - - t c~
Proposed Facility: Desip Flow (.1949): 361'J Property Size: -5-4C4,t
Location of Site. Property Record:
Water Supp r. lic ❑ Individual ell ❑ Spring ❑ Other
Evaluation Method: ~,tlger Horin9 ❑ pit cut
Type of Wastewater: a Sewage ❑ Industrial Process Nfixed
P
R
O
F
SOIL MORPHOLOGY
OTHER
1 .1940
.1941
PROFILE FACTORS
L L.andoc"
Horizon
.1941
E Position/
Depth
.1941 .1941
ut
.1943
.1936
1944
Proflb
# slope %
00
Struch" Consistence
watrwwl
soil
Sqm
.
Restr
Clan
Te~dun
Mimmlo
Color
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Hasix
A LTAR
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6• L o y
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Cxher Factors (.1946k
Item site ctaui6cation (.1948y U- PS
huen By:
Others