IPACHTE# //-5-•-Z66 Harnett County Department of Public Health
Improvement Permit 2 6 4 2 6
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: /6' ' c'/ GSo~
ISSUED I ! 1 t.1 /2~74- .5 fl SUBDIVISION LOT #
NEW REPAIR EXPANSION El Site Improvements required prior to Construction Authorization Issuance:
Type of Structure:
Proposed Wastewater iN T.vae: Z -6- `
Projected Daily FlowGPD
Number of bedrooms: Number ofOccupants: max
Basement ❑Yes o
Pump Required: ❑Yes ❑ No Ma ee required b on final location and elevations of facilities
Type of Water Supply: ❑ Community L!1 Public Well Distance from well 9 04 feet
Permit conditions:
Permit valid for:
ten rive years
❑ No expiration
Authorized State Agelfi Z- I" Av-r t Date: :5 - X I SEE ATTACHED SITE SKETCH
The issuance of this permit by" 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 Permjt)
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:
PROPERTY LOCATION: ,/Ze
SUBDIVISION
LOT #
Facility Type:
t~
11 New ❑ Expansion ❑ Repair
Basement? ❑ Yes
No Basement Fixtures?
❑ Yes No
Type of Wastewater System**
471
254 A01-
(Initial) Wastewater Flow: GPD
(See note below, if applicable '
'lr, ljrac (Repair)
Installation Requirements/Conditions Number of tre hes e-f
Septic Tank Size -1 gallons Exact length of each trench /00 feet
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of: Z& i c es
(Trench bottoms shall be level to +/-1/4"
in all directions)
Pump Requirements: ft. TDH vs. GPM
Conditions:
Trench Spacing: Feet on Center
Soil Cover: inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
41 inches below pipe
Aggregate Depth: inches above pipe
1 Z- inches total
WATER LINES (INCLUDING IRRIGATION) MUST BE LOFT. FROM ANY PART OF SEPTIC SYSTEM OR REPAIR AREA.
NO UTILITIES ALLOWED IN INITIAL OR REPAIR DRAIN FIELD AREA.
**If applicable: / understand the system type specified is different /rom the type specified on the application. /accept the specifications of this permit.
Owner/Legal Representative Signature: Date:
This Construction Anthnrization is suhiert to revnratinn if the site nlan. nlat or the intended use changes. The Construction Authorization shall not be transferred when there is a change in ownershio 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 *i~~ 2 Date: 3 -1&
Construction Authorization Expiration Date: •3 / - 140
a
6
t
007-
Depaztment of Environment, Health and Natural Resources
Sheet:
Division of E Mmumeutal Health
On-Site Wastewater Section
Property 1D:
e
Lot
SOII,/SITE EVALUATION
File
Code:
ror ON-SITE WASTEWATER SYSTEM,
Owner. Applicant:
Address: Date Evaluated:
Proposed Facility: Design FCaw (.1949): Y
Property Size:
Locatiomi of Site: PM01 1morded:
Watts Supptp IiC ❑ Individual Well
❑ Spring ❑ Other
Evaluadon Method: Auger Boring ❑ Pit
Type of Wastewater: S
❑ I
l
Cut.
ewage
lx
ustrial Process [
INixett
P
R
O
P SOU. MORPHOLOG
Y
1 .1940 .1941
L [.arduapa Horizao
PROFILt; FACTO
RS
%
E P0slti Depth .1941 .1941
4 91opa 7U (Li) Struchow Considema
,1942
.
Soil
Wetand
'
1943
.1916 .1944
Fro M®
Taxwe Minral0
Color
9011
Pogo
S®pm ft*
CIA= Hans.
Ctar
ALTAR
v !3
B .
a
50-32,
J
L 1®
6
21~ ~n-
w
aapa~ ayaU"o "her Factors (.1946)
--r'' Site C1ms18cadon (.1948X F-_S
Evaluated By:
Others Present: