IPACH T E # Harnett County Department of Public Health
Improvement Permit 26328
A building permit cannot be issued with only an provement P mi
PROPERTY LOCATIO :~S.d- _
ISSUED TQ; ~ 2c~S im1 ~ v ° SUBDIVISION Ci-g4r.` LOT #
NEW Z REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: -,F 1 L
Proposed Wastewater System Type: sS'hC~(~ns' 3°;i~ P~•rSjrf~"`
Projected Daily Flow: GPD
Number of bedrooms: Number of Occupants: ` max
Basement ❑Yes
Pump Required: ❑Yes ❑ No 9be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community MaPublic ❑ Well Distance from well feet Permit valid for: IJ Five years
Permit conditions: ❑ No expiration
Authorized State Agent: f/~ c' V Date: 5 / Y4 AW SEE ATTACHED SITE SKETCH
The issuance of this permit b Health D partment 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 i 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 bb installed in accordance
with the attached system layout. t /
ISSUED TO: SC PROPERTY LOCATION: 4,rf l P T"~.1--ft A
/ SUBDIVISION yn ~....°-OU, g LOT # _
Facility Type: $ 2 New ❑ Expansion ❑ Repair
Basement? ❑ Yes ❑ No Basement Fixtures? ❑ Yes ❑ No
Type of Wastewater System** cl~lte tjl~ /f' at (Initial) Wastewater Flow: GPD
(See note below, if applicable
,~(Repair)
Installation Requirements/Conditions Number of trenches
Septic Tank Size C 0 gallons Exact length of each trench JM feet Trench Spacing: 9 Feet on Center.' i ~
Pump Tank Size fG0 gallons Trenches shall be installed on contour at a Soil Cover: _ inches s.
Maximum Trench Depth of: 1JL-16 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. TDH vs. GPM inches below pipe
Or Aggregate Depth: inches above pipe
, emditio s' 0 C rc j n of c~ ( 4- 'AZ- J inches total
WATER LINES (INCLUDING IRRIGATION) MUST BE LOFT. FROM ANY PART OF SEPTIC SYSTEM OR REPAIR AREA. S nJ ``A5 -rV s' i%-
NO UTILITIES ALLOWED IN INITIAL OR REPAIR DRAIN FIELD AREA.
**If applicable: /understand the system type rpecifed is different from the type .specified on the application. / accept the .rpecilcationr of this permit.
Owner/Legal Representative Signature: Date:
This Construction Authorization is subiect to revocation if the site clan. Dlat, 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: Date: A
`elf
Construction Authorization Expiration Date:
HTE# e2 L 0' ~ Permit # o,(- d- 6
Harnett County Department of Public Health
Site Sketch
q / -D r PROPERTY LOCATON:
ISSUED TO: a,,r r'A &qv- t. Cj- SUBDIVISION O ft ry LOT #
Authorized State Agent: '~a+ a Date:
p`c f-J(-
t
Department of EmIronment, Health and Natural Resources Sheet:
Division of Environmental Health Property ID:
On-Site Wastewater Section Lot
SOMSITR EVALUATION File
for ON-SITE WASTEWATER SYSTEM: Code:
Owner. Applicant: q
Addmsa; Date Evacuated /~~~at
Proposed Facility: Descgp Flow (.1949): Property Size:
Locatcoa of Site. Property Recorded:
Watet Siupplp; ( IlC 0 individual ❑ Wen ❑ Spring ❑ Othee
Evaluation Method: ger Boring ❑ pit . cut
Type of Wastewater. ❑~S newage ❑ wushial Process mixed.
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others By.
Others Present: 6
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