IPACHTE# II i-a. t4 r Harnett County Department of Public Health
hDrovement Permit 2 6 3 4 4
A building permit cannot be issued with only an Improvement Permit
/ PROPERTY LOCATION: 00,2 r Xd.
ISSUED TTo. a_.7 ,lrt,~ Gdt.d'ts~ ; c~ SUBDIVISION I & St_ LOT # f ~
NEW Z7 REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: ~ -F b (sC k6(u
Proposed Wastewater System Type:
Projected Daily Flow: ~L~C3 GPD
Number of bedrooms: Number of Occupants: _e max
Basement ❑Yes 210
Pump Required: ❑Yes E2 No ❑ Ma be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community Public ❑ Well Distance from well feet Permit valid for: I3 Flve years
Permit conditions: ❑ No expiration
Authorized State Agent:: L r / ~i , X Date: V1 2- 12-041 SEE ATTACHED SITE SKETCH
The issuance of this permit by thecflealth Department in no ay guts arantees 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 TO: ~QVi,, CgaT ~d~,c +ac~ PROPERTY LOCATION: cct °~f,
t _e_
SUBDIVISION r,, f 2 ' LOT # /0
Facility Type: L+d New ❑ Expansion ❑ Repair
Basement? ❑ Yes No Basement Fixtures? ❑ Yes ❑ No
Type of Wastewater System** o~ lea V4, (Initial) Wastewater Flow: GPD
(See note below, if applicable
(Repair)
Installation Requirements/Conditions Number of trenches a2
Septic Tank Size QQQ gallons Exact length of each trench ZOO feet Trench Spacing: Feet on Center
Pump Tank Size gallons Trenches shall be installed on contour at a Soil Cover: id-/8 inches
Maximum Trench Depth of. le, -,JU 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
Aggregate Depth: inches above pipe
Conditions:
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 from the type specified on the application. / accept the specipcations 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 ownershin 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: X G 2-Olt _
Construction Authorization Expiration Date: A Z 75-
HTE# Permit # c>~- ~z J W
Harnett County Department of Public Health
Site Sketch
PROPERTY LOCATON: t
ISSUED T0:SUBDIVISION LOT #
c
Authorized State Agent: Z-tc,
Date: au~/
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Dgmftent of Envimnmenk Health and Natural Resomvgs Sheet:
Division OfElMrOamental Health
On-Site Wastewater Saotlou Property ID:
Lot i!:
SOIIJSITB EVALUATION File 0:
for OPf,SITE WASTEWATER SYSTM: Cade:
Owner. Applicant:
Address: Date Evaluatad; Vl ®1 `
Proposed Facility: Design Flaw (.1949): Froperty Size:
Lacado Site: Property Recorded:
Watet supply; 11C ❑ hxNdud ❑ Well ❑ Spring cut
Evaluation Method: c ,go Boring ❑ Pit.
Type oB 1~Vasteavvate~: ('Sewage ❑ Industrial Process Mixed.
P
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F IL N10"Howoy R
1 .1940 .1941 PRO
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Paaide1941 1941 .1941
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1-1,rV
truer Factors (.1 %6) -
Site ClassiBcadtm (.1948k/
Evahated By:,0,,%,
Mal Prosmt:cv 1,
❑ Other
1,9 j 1944
'apm Re*
'lase, Harl=.
i LTAR
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