IPACHTE# 11Harnett County Department of Public Health
Improvement Permit 2 6 5 6 6
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: -'Cisa Gent
ISSUED TO: NQ C-C) "s ZZ cz.r" c -r" SUBDIVISION ~iR1-AGE LOT #
NEW,, REPAIR ❑ EX SION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: = 4F`~L>'
Proposed Wastewater System Type: C.~ 4avEr`rse o Dc 1~
Projected Daily Flow: 3(-Q GPD
Number of bedrooms: 3 Number of Occupants: Amax
Basement ❑Yes XNo
Pump Required: ❑Yes °~No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community '~k Public ❑ Well Distance from well 1 O 0 feet Permit valid for: 'Five years
Permit conditions: ❑ No expiration
Authorized State Agent:: Date: 51,61 11 SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the iss 5liof other permits. 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 Improv ent 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: ~Q ~ cN~,G'Sly~ PROPERTY LOCATION:7')N( f'f'N
SUBDIVISION - 71,, r- EN LOT # k l
Facility Type: )g~ New ❑ Expansion ❑ Repair
Basement? ❑ Yes 'tR„ No Basement Fixtures? ❑ Yes XNo
Type of Wastewater System** CO Nv E.,T_1 \ d N-tat, (Initial) Wastewater Flow: 3('~ GPD
(See note below, if applicable
Co'..ag.'rs tom.: , (Repair)
Installation Requirements/Conditions Number of trenches 3
Septic Tank Size 1 (Z> Z05Z) gallons Exact length of each trench a feet
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of:~ 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: inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
Aggregate Depth:
inches below pipe
inches above pipe
13, 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 speciped is different from the type speciped on the application. l accept the specifications of this permit
Owner/Legal Representative Sj nature: Date:
This Construction Authorization is subject to revocat1 he site plan, at, 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 stCh~'ec*~&compliance w e;i;Lv ' of &ie s and Rules for Sewage Treatment and Disposal and to the conditions of this permit. SEE ATTACHED SITE SKETCH
Authorized State Agent: 7~ - y~~~ e".5 Date: $ `0 t
Constr t n Authorization Expiration Date:
HTE# 11-
ISSUED TO:
Permit # 'QL 6sf~
arnett County Department of Public Health
Site Sketch
Authorized State Agent:
PROPERTY LOCATON: "-ViN 6E ~c
SUBDIVISION `~N~~'~ QLC~GE LOT # 'i
Date: 151 6~
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9
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1+d G~.UO E$
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M,~a.o r.do2N
Department of Environment, Health and Natural Resources
Division of F.nvifonmental Health
Sheet:
On-Site Wastewater Section
Property ID:
Lot
SOUJSUZ EVALUATION
File 0:
for ON-SITE WASTEWATZR SYSTEM
Code:
Owner. Applicant;
Addrem- Date Evaluated:
P
ili
d F
ce
ropose
ac
ty: 3 >Q=~
DedP Flow (.1949): kC `a
Pmpcit3► Size:
LocaNOn of Sher. Property Recorded:
•
water Supply; PubllC ® hxwdual ❑ Well
M
❑ Spring
❑ Oth
Evaluadoa
ethod: 4}luger Boring pit
Ell
cut
er
Type oP~Vasiervater. "Sewage ❑ Industrial Process
M
ixed.
P
R
O
1 SOIL MORPHOLOGY
1
t940
OTHER
.
L .1941
LandKap~ Haizoa
PR DRU FACTORS
E .194'
Paetttod Depth 11941 .1941
N slope % (1a) strucubw Coast as SWeoil oll
t';
.1956 .1941 1iro111r
TOM" Mteenlo Color
Q
o-mil,
9oA)
Sepro Re* Clan .
law Hatt, Al LTA1R
- - " Site ClarsiBcatlou (.19482
c o r_""- Evahzted Bye; ;
c1 Others Presemh