IPACHTE# A -5-2~69`71A Harnett County Department of Public Health
Improvement Permit
26 569
A building permit cannot be issued with only an provement Permit
PROPERTY LOCATION: oc's 9,0
G
A
yrAN
y
ISSUED TO:
Gi \ o'-4
SUBDIVISION ~szcf SE,25 14.NoGE
LOT # tO
NEW REPAIR ❑
EINSION ❑
Site Improvements required prior
to Construction Authorization Issuance:
Type of Structure: 5 ~S~(C.6
fOO 1
Proposed Wastewater SystemcT,~pe: `a-S "~o Q C-.Ova; 0
I RI
~
O
Projected Daily Flow:
GPD
Number of bedrooms: 1-1
Number of Occupants:
max
Basement ❑Yes >l No
Pump Required: ❑Yes No
❑ May be required based on
final location and elevations of facilities
Type of Water Supply: ❑ Community
-~14 Public ❑ Well
Distance from well 100 feet
Permit valid for: 'Five years
Permit conditions:
❑ No expiration
Authorized State Agent:: W,-W Date: 15113111 SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the issuance o t r permits. The permit holder is res onsible 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 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. a^~
ISSUED T0: ~-A PROPERTY LOCATION: ,.J oc~S Q--.o
SUBDIVISION 1 a.0-IISF 6 " 0C-F- LOT # i®
Facility Type: New ❑ Expansion ❑ Repair
Basement? ❑ Yes A No Basement Fixtures? ❑ Yes Type of Wastewater System** p.!S-0 a SZr-OQ0- O~~N
`t5T't- %
(See note below, if applicable
2-S'94 ~2~ U~ 1 b r\1 (Reoa
Installation Requirements/Conditions
Septic Tank Size L ® (ZI ~b gallons
Pump Tank Size gallons
Pump Requirements: ft. TDH vs.
Number of trenches
Exact length of each trench feet
Trenches shall be installed on contour at a
Maximum Trench Depth of. 1 - inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
GPM
Conditions:
(Initial) Wastewater Flow: L'F80 GPD
Trench Spacing: ~ Feet on Center
Soil Cover: Cl -11,. inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
Aggregate Depth:
inches below pipe
inches above pipe
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: I understand the system type specified is different from the type specified on the app/ication. / accept the specipcations of this permit.
Owner/Legal Representative Signature: Date:
This Construction Authorization is subject tc tion if the site pla plat, 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 subjert to~ompliance wi the 'ons of Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit. SEE ATTACHED SITE SKETCH
Authorized State Agent:
Date: 5 1 )31 t~
Constr n Authorization Expiration Date: d
HTE# Permit #
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1ZE;-tvi Uc;\"4 aE126--i 1-N
Department of Envimamenk Health and Natural Resources
Divisioa of Environmental Health
Sheet:
On-Site Wastewater Section
Property ID:
Lot 0:
SOIIJSITE EVALUATION
File 0:
for ON-SITE WASTEWATZR SYSTE MtF
Code:
Owner. Applicant: J
Address: Date Evaluated: '14u-la o
Proposed Facility: Deslgp Flow (.1949).
Locattica of Site: Property recorded:
Property Size:
Water Supply; IBC ❑ Individual ❑ Well
Evaluation Method: NS
user Baring ❑ Pit .
Type of 1~11awateu!:
❑
Cut ❑ Spring other
wage ❑
4
Industrial Process [
Mixed
P
R
O
F
t .1940
SOU, MOMOLOGY
t941
OTHER
L L wdmp Ho lZoe
9 Po hlad Depth
.1941 .1941
.1941 soil
PROFRA FACTORR
N Slop 9ti
ftum d Cow lea We4reia!
Teidun Miaereto
Color
A0,0
19J6
S0U S'pro
.19" mini
Reatr Clem
tv ®'2.C ~j L5- Jtf~~
owl. Ctut
Hons. ~ L1'A>t'
` r
C}-/U C-
! Cl - .2ff
6/7
~-rY lr V~
11
D0f°'
P
00 s w Re sy.tam Other
Factors (.1946k
Avedebte S ea .1943Site C1uliBcadou (.194OX
s ,dem Evaluated By
She LIAR L.S , Others Proaent:
u -r C '