IPACH T E # e~ Z-? y0. Harnett County Department of Public Health
hDrovement Permit 2 6 61 6
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: Y It Aj
ISSUED T : 19 /DcIJ'~w SUBDIVISION LOT #
NEW REPAIR ❑ EXPANSION ❑ Site Imp ements required prior to Construction Authorization Issuance:
Type of Structure: '_bW tt1 14 Zk Kb tm'
Proposed Wastewater System Type: IrXX ,L -Auc„- ®kt 'r
Projected Daily Flow: J 6 GPD
Number of bedrooms: 3 Number of Occupants: b max
Basement ❑Yes R No
Pump Required: ❑Yes Ind No ❑ May be required b ed on final location and elevations of facilities
Type of Water Supply: ❑ Community ❑ Public Well Distance from well 00 feet Permit valid for: 2/Five years
Permit conditions: ❑ No expiration
Authorized State Agent:: zis- Date: Y/ SEE ATTACHED SITE SKETCH
The issuance of this permit by a 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 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 T0: CJ PROPERTY LOCATION: Foq -1~ cl','4 r
SUBDIVISION ~`aAA G ?v`, ~ysa LOT #
Farility Tvnp _DW 14 '2o Y(.~ O' New ❑ Exaansion ❑ epair
Basement? ❑ Yes 1~' No Basement Fixtures? ❑ Yes ❑ No
Type of Wastewater System** (Initial) Wastewater Flow: GPD
(See note below, if applicable
fi J'4 (Repair)
Installation Requirements/Conditions Number of trenches
Septic Tank Size /00 Q gallons Exact length of each trench ~5 0 feet Trench Spacing: Feet on Center
Pump Tank Size gallons Trenches shall be installed on contour at a Soil Cover: 8 inches
Maximum Trench Depth of: 02~ 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 inches below pipe
Aggregate Depth: inches above pipe
Conditions: 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 ty Pe specired is different from the type specified on the application. / accept the specifIcations of this permit.
Owner/Legal Representative Signature: Date:
Thit rnnstmrtinn Anthnri7nfinn is suhiect to revocation if the site plan. olaL 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. SEE ATTACHED SITE SKETCH
Authorized State Agent: Date: 7 / 46
Construction Authorization Expiration Date: / tie v / c'
HTE# ,5 -,Z7 003 Permit # a \a ,
arnett County Department of iblic Health
Site Sketch
_ PROPERTY LOCATON: J.o
ISSUED TO: 44Z- , ~G SUBDIVISION LOT #
Authorized State Agent . Date: 7//~G✓/
,
G-
5-Cc.'
Department of Environment, Health and Natural Resources Sheet:
Division of Eavironmeatal Health •
On-Site Wastewater Section Property 1D:
Lot 0:
SOUJSITE EVALUATION File M:
for ON-SITE WASTEWATER. SYSTEM: Code:
Owner. Applicant; Address: Date Evahtata 1Proposd Facility: Design Ffaw (.1949): Properly Size:
Lacado>E of Site: Projeity Recorded:
WatetBnppty` IC ❑ Individual [Well ❑ Sp~g
Evaluation 14fe- hYA ger Boring ❑ Pit . Cut_
Type of Wastewater. ❑ Induswal Process Mixed.
P
x
a
F Soa Mo"HO[.oav
t .1940 .1941 HER
PROFtI$ PACTC
L Land~eape Hodzoa .194'
E Posidod Depth .1941 .1941 S611 144s
a clop. K tom) strucdvd Vcmdem we Ou
Ted Mtaerelo Color
61,
- MG/6
c .)1//7c Z jf~
❑ Other
.1936 1941 Plroltl®
8~pro Rsatr CIar1
Ctan Hods. A LTAR
4 3
a YWnam%.a a-mj,
Site C19sSificaHon (.1948X /1
Evehated By: