IPACHTE# 11-5- ~3aN Harnett County Department of Public Health
Improvement Permit 2 6 5 0 0
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: Ttv~,v
ISSUED T0: ti ~•,-L~~cs SUBDIVISION _ e4~ Rc1 gas o~ LOT # '7%
NEWX1 REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: 0
Proposed Wastewater System Type: 2 °lo yC.~ d N '3ys-S m
Projected Daily Flow: GPD
Number of bedrooms: Number of Occupants: max
Basement ❑Yes No
Pump Required: ❑Yes No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community ~ Public ❑ Well Distance from well lC>d feet Permit valid for: Five years
Permit conditions: 1\ ❑ No expiration
Authorized State Agent:: \ Date: 1 SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the issuance of ermits. The permit holder is r ponsible 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,
with the attached system layout. .1954, .1955, .1956, .1951, .1958. and .1959 are incorporated by references into this permit and shall be met. Systems shall be installed in accordance
ISSUED T0: ~ozti -1-5 o~'c5 PROPERTY LOCATION: 1)N ctr.N Q-0
SUBDIVISION t-~ s Pay LOT # -1"RT
Facility Type: N New ❑ Expansion ❑ Repair
Basement? ❑ Yes X No Basement Fixtures? ❑ Yes No
Type of Wastewater System** as/6 V--V--Zv 0 (Initial) Wastewater Flow: GPD
(See note below, if applicable Q
AN G2 3-> -.Oc -,r (Repair)
Installation Requirements/Conditions Number of trenches t _
Septic Tank Size f dp O gallons Exact length of each trench a feet
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of, a~i-3O inches
(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: 1~ inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
inches below pipe
Aggregate Depth: inches above pipe
inches total
WATER LINES (IN(LUDING IRRIGATION) MUST BE ]OFT. FROM ANY PART OF SEPTI( SYSTEM OR REPAIR AREA.
NO UTILITIES ALLOWED IN INITIAL OR REPAIR DRAIN FIELD AREA.
**If applicable: / understand the system type speciled is different from the type spelled on the application. / accept the specilcations o/this permit.
Owner/Legal Representative Signature: Date:
This Construction Authorization is subject to revocation if to pl plat, or the intended use changes. The Construction Authorization shall not be transferred when there is a change m ownership of the site. This
Construction Authorization is s ' c compliance h th ision aws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent: Date: 'A 6 1
Cons ion Authorization Expiration Date: t'a b
HTE# Permit # aQ50 Q)
Harnett County Department of Y~iblic Health
Site Sketch
PROPERTY LO(ATON: - d-N (.t-"j -~.D
ISSUED TO: 12) VC) r►,E SUBDIVISION ~ 1o svs Po> LOT #
1
Authorized State Agent: a bl-y Z~c Date: L' ! r,'
r
~a
D
V
E
V ~-j ~L>Cj~2 Q)(L.
Deparhnent of Enviivnmenk Health and Natural Resources
Division of EnviroameaW Health Sheet:
On-Site Wastewater Section Property ID:
Lot 0:
SOu jsITE EVALUATION File P
for ON-SITE WASTEWATERSYSTYM Code:
Owner. Applicant:
Address; Date Evaluated:
Proposed Facility: 3 q-, 6D ~co.°~ pdgD F►bw (.1949): 3 ~0 <
LacatloQ of Site: Property geoorded: P10 r" Size:
Water Supply; : 13~Pubgd ❑
Evaluadon rvfdhod: G~Auger Boring ❑ C1 Well 13 5pdng
pit
Type of Wastewater. Sews90 ❑ Industrial P
rocess Cut
Mixed
P
R
O
1 . SOIL MORPHOLOGY
1 .1940
m .1941 PRO
b71.8 FA~.'tO
t; el t>~pth .1941 .1941
.1941
stuamw Conii~taace soil 1511
ToMur~ Mtawla Wehta~l soil
i LS Color I1V,
Vv- I
30 4
Sl~'
-a-
ether Factors (,1946
Site Ct&WCad0fl (,1948k
Evahwted By: c~
Others Present:
❑ Other
.1996 .1944 ftmi
gopm
Ct can
Harts. Ai LtA>t
.f
. L~
F a-.