IPACHTE#~f Harnett County Department of Public Health
Improvement Permit 26 512
A building permit cannot be issued with only an Improvement x4A~v PROP ERTY LOCATION iZ ~
ISSUED TO: - C) I G/ SUBDIVISION LOT #
NEW ❑ REPAIR ❑ EXPANSION
Type of Structure: F-17( sr
Proposed Wastewater System Type:
Projected Daily Flo of p?ac't t j
Number of bedrooms: Number of Occupants: max
Basement ❑Yes Z No
Site Improvements required prior to Construction Authorization Issuance:
Pump Required: 27es ❑ No ❑ May be required bb d on final location and elevations of facilities /
Type of Water Supply: ❑ Community El Public Zell Distance from well !SW feet Permit valid for: L~~ Five years
Permit conditions: ❑ No expiration
Authorized State A t:: v WIA)IV114A Date: f - ! 1 " I t SEE ATTACHED SITE SKETCH
The issuance of this permit by In 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 id 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, .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. ~r /
ISSUED TO: 7~d 0f F PROPERTY LOCATION: 5'C/-T4-Z uz,
S (VISION LOT #
Facility Type: ❑ New Expansion ❑ Repair
Basement? ❑ Yes No Basement Fixtures? ❑ Yes 17`No
Type of Wastewater System** tfc> ~5 (Initial) Wastewater Flow: L R GPD
(See note below, if applicable ❑
)
>rpair)
Installation Requirements/Conditions Number of trenches q
Septic Tank Size /000 gallons Exact length of each trench feet
Pump Tank Size 1006 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)
inches below pipe
Aggregate Depth: c" inches above pipe
/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 from the type specified on the application. l accept the specifications of this permit.
Owner/Legal Representative Signature: Date:
This Construction Authorization is subiect to revocation if the site Dian, slat, or the intended use changes. The Construction Authorization shall not be transferred when there is a chance in ownership 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 ent: Date:
Construction Authorization Expiration Date:
HTE# Permit # Z.
Harnett County Department of INiblic Health
Site Sketch
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Department of Environment, Health and Natural Resources
Division of Mmironmental Health Sheet:
On-Site Wastewater Section Property ID:
Lot
SOUJSIiT9 EVALUATION File M:
for ON-SITE WASTEWATER SySTEr4 Code:
Owner. Applicant: -Z eS
Addtesa: Date Evaluated6-/,!5;//
PropesedFacility: 4/)0 '-6 Design F10w (.1949Y ?
Locatioi d Sits: Prop'etty Recorded: Pr°pertl' Size:
Water $upglp;: (ThblIC ❑ individual [Well ❑ Spring
Evaluaeon Mme: Auger Boring 13 Pit . cut.
Type o( wastewater Sewage ❑ Industrial Process Mud
P
R
O
F . San. MO"HOLMY
1 .1940 .1941 FROM VAcTC
Pe Hat'zoo 1941
E Poaidad Depth .1941 .1941 son T „ 1~~
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Tendon Mtnrelo
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Wetaew
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qz 7-
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e
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❑ Other
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.1956 .1944 homes
Sapm Re* Ctm
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Site ClaWC8don (.1948k
Evehutted IIy:
Other, Prem me r'°`