IPACHTE# 1 %Z - Harnett County Department of Public Health
hDrovement Permit 2 6 61 2
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: k-) CA .
ISSUED T SUBDIVISION 7'v'- 7f^'E I i'dS e LOT #
NEW REPAIR ❑ e EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: ~S-FD LG )((.o
Proposed Wastewater System Type: _c25--& Projected Daily Flow: q e C' GPD
Number of bedrooms: C - Number of Occupants: g max
Basement ❑Yes L9 No r
Pump Required: ❑Yes ❑ No VMMaybe required based on final location and elevations of facilities
Type of Water Supply: El Community 1 Public ❑ Well Distance from well y~ feet Permit valid for:
Permit conditions:
Five years
❑ No expiration
Authorized State Agent:: kr/.Jt . - c,-- ,c~/(I Date: 6 /~-SEE ATTACHED SITE SKETCH
The issuance of this permit the 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 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 Perrnit)
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.
I
ISSUED T0: PROPERTY LOCATION: I 3-1.
SUBDIVISION 7-rQ d LOT #
Facility Type: iF R6ew ❑ Expansion ❑ Repair
Basement? ❑ Yes I" No Basement Fixtures? ❑ Yes ❑ No
Type of Wastewater System" ~~t/Z, (Initial) Wastewater Flow: /L a GPD
(See note below, if applicable
(Repair)
Installation Requirements/Conditions Number of trenches
Septic Tank Size 00gallons Exact length of each trench cat `10 feet
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of: 18 ° ✓7c-~ inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
Pump Requirements: ft. TDH vs. GPM
Conditions:
Trench Spacing: l Feet on Center
Soil Cover: 6 16 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 10FT. FROM ANY PART OF SEPTIC SYSTEM OR REPAIR AREA.
NO UTILITIES ALLOWED IN INITIAL OR REPAIR DRAIN FIELD AREA.
**If applicable: l understand the system type specired is different from the type speciTed on the application. / accept the speciTcations 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 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. Itt AI IALHtU ME NKtIIH
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Authorized State Agent- C° Date: 612,7 ZZ
V /
Construction Authorization Expiration Date: lra 1 / z c
HTE# f - a C) Permit # c~ Ala E Z
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Depart rent of Environment, Health and Natural Resources Sheet;
Division of Environmental Health
On-Site Wastewater Section Property ID:
Lot
SOIUSITR EVALUATION File 0:
for ON-SITE WASTEWATERSYSTEM Code:
Owner. Applicant:
Address:
G t z Z k5li r
D
t
E
l
.
Propow Facility:
Location o(Site:
a
e
va
uated:
Deslgtt Flow (.1949):
Pmperty Size:
Property Recorded:
Water Supply;<.
M
( t!C ❑ Individual
Wa
Weil
Spdng
Evaluadoa
ethod:
Type oP Waswmter
[
ger Boring ❑ p
l
S
,
.
j
ewage ❑ Industrial Pro
cess
P
R
O
P
i
1940
SOIL MORPHOCAOY
d` 7iF.R
.
L I UXIMpe Hatzoa
.1941
PROFRA FACTO
N 9top~ 7r 00
• 1941 .1941
sh
.1941
soil
1449
xftwd Canditme
Ted Mtamto
Welled
color
Soil
IN
,
28
❑ Other
.1956 .194 home
38pre Re* CIS*
Clan .
Haas, ALTAR'
/Jl
Site Clawradon (.1948k P~f
EvdmWd By:
Others Present: c