IPACHTE# 11-5-a6-- Oy Harnett County Department of Public Health
Improvement Permit 26589
A building permit cannot be issued with only an Improvement P rmit
PROPERTY LOCATION: M ?%Q.*5
ISSUED TO: C- V TV-% Q ArA Q a s~ tit SUBDIVISION a - vrz.P LOT #
NEW:, REPAIR ❑ E{ NSION El Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: Q `L~''- s" 1
Proposed Wastewater System Type:
Projected Daily Flow: L't '10 GPD
Number of bedrooms: LAC Number of Occupants: c-9 max
Basement ❑Yes X No
Pump Required: ❑Yes 1!~,No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community -X Public ❑ Well Distance from well 1, fDo feet Permit valid for. Five years
Permit conditions: ❑ No expiration
Authorized State Agent:: Date: SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the issuance t ermits. The permit holder is responsibl 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.
ISSUED TO: CU MQ)r-tip-40 pct c ,A1G PROPERTY LOCATION: P A
SUBDIVISION ~snV,E0t1A LOT #
Facility Type: CD"FQCLV"i' xS1?S~ New ❑ Expansion ❑ Repair
Basement? ❑ Yes X No Basement Fixtures? ❑ Yes XNo
Type of Wastewater System** o f o Q4---y v C-1~ \ 0 s t S-y -5~ a rr,-N (Initial) Wastewater Flow: GPD
(See note below, if applicable
~.S°lo QED U 0 W CE5~ 575.rn (Repair)
Installation Requirements/Conditions Number of trenches `1
Septic Tank Size 4 ®®4 gallons Exact length of each trench S O feet Trench Spacing: Feet on Center
Pump Tank Size gallons Trenches shall be installed on contour at a Soil Cover: 2 inches
Maximum Trench Depth of: 4-4y-3Z 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
Conditions:
inches below pipe
Aggregate Depth: 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: /understand the system type speciled is different from the type speciled on the application. / accept the specifications of this permit.
Owner/Legal Representative Sign Date:
This Construction Authorization is subject to revocation,, A site plan, 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 subjectty~mpliance witpro they nd Rules for Sewage Treatment and Disposal and to the conditions of this permit. SEE ATTACHED SITE SKETCH
Authorized State Agent: qQAS Date:
Cons tf Authorization Expiration Date:
HTE# t 1 ° S - °a(~D'2A I
Permit # ar. 5I C,
Harnett County Department of 1"tiblic Health
Site Sketch
ISSUED TO:
Authorized State Agent:
PROPERTY LOCATON: M 9--~) _
r SUBDIVISION ~5`~G~cr2o LOT #
w Est,701-y-spb ate: c
}
e
\3 ` 1'
L--0 c..-~: -N om P (L
Department of Emimamenk Health and Natural Resources
Division of Enviroumental Health shed:
On-Site Wastewater Section Property ID:
Lot
S0UJSM EVALUATION File 0:
for ON-SITE WAST19WAuRsymm Code:
Owner. Applicant:
Address:.
Date Evaluated:
Proposed Facility: bi 61~2d 0 M Dplgh Flaw (.1949): IV-c) 5
~
L
i
Propert
Si
ocat
olEo(Site.
e
Pro"atty
p
1~teoorded:
y
ze:
Water Suppijr -
E
l
d
n M
❑ Pubtlc ❑ Individual ❑ We11
❑ S tin
p
va
ua
o
ethod:
❑ Auger Boring ❑ Pit
g
cut
.
Type of Wastewater:
❑ Sewage ❑ lndustriat Process
Mixed
p
R
O
P
1
1940
SOIL MORPHOLOGY
OfIiER
.
L 1 nick o Horizon
.1941
PROFU FAL'IOR:
N 9
1942
.1941 .1941
3oi1
Str
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h:
.1443
uclun
Candrtenra We4iaW
ToM~ MtMlo Cola
9ai1
M's
nY
11-4- VC<t 1;4W
um r Factors I M)
Site Classillcattou (,1948k S
Evahzted By
c~ C
Others Ptresene
❑ Other
.I9S6 .I94/ PYoiq®
CIA" Realr Ctw .
Hats. A LTA1t
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