IPACHTE# ,Harnett County Department of Public Health
Improvement Permit 2 6 6 5 2
A building permit cannot be issued with only an Improvement Permit
ISSUED T0: ~ Scz sy G ~-t2,o:~'a LZ,C~- PROPERTY LOCATION: 0 lk~
SUBDIVISION 6N6- Cgos5 LOT# Id2,
NEW REPAIR ❑l ANSION El Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: 5 BCD G~' ~
Proposed Wastewater System Type: -$o~° b ~ovGs ►otV
Projected Daily Flow: 36~ GPD
Number of bedrooms: :5 Number of Occupants: max
Basement ❑Yes )No
Pump Required:'es ❑ No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community Public ❑ Well Distance from well l OQ feet Permit valid for: Five years
Permit conditions: ❑ No expiration
Authorized State Agent:: ~ v um-5 Date: -11 ) 1 SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the iss a of ther permits. The permit holder is res nsible 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 Impro cent 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: PROPERTY LOCATION: O
yEaZ NILL'5
SUBDIVISION S ; d Ntr
e: x-14 x5'G X New ❑ E
Facilit
T
i
❑ R
i
LOT # 10~
y
yp
xpans
on
epa
r
Basement? ❑ Yes 'IR, No Basement Fixtures? ❑ Yes XNo
Type of Wastewater System** P u cnq o °/a p r, `j~l s-CGM
(Initial) Wastewater Flow: -6C-O GPD
(See note below, if applicable
(Repair)
Installation Requirements/Conditions Number of trenches '3
Septic Tank Size 1 o p 0 gallons Exact length of each trench 40 feet
Trench Spacing: ~ Feet on Center
Pump Tank Size La®b gallons Trenches shall be installed on contour at a
Soil Cover: r. inches
Maximum Trench Depth of: l -a~ 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: a.enrs ~a~6s7 Q~Ai'Q~p`L- bm L55 12- inches total
WATER LINES (INCLUDING IRRIGATION) MUST BE ]OFT. 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 specifed on the application. / accept the specifIcations 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 ovisio the laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent: RG-~1S Date: _
Cons tion Authorization Expiration Date: a I
HTE# ~)-'S~al
Permit # ~-L (b
Harnett County Depairlment of Public Health
Site Sketch
PROPERTY LO(ATON: O vim-X11--Ls
ISSUED TO: ~Sa ~;bss --1--~- SUBDIVISION 5 ~ dN~ Gcz o55 LOT # 10-4-
Authorized State Agent:51~t~vE3~ "~o~kStX~t Date: `7~ l ►1
12A-1
i ) ..-t, ,
`JS 0 N G)4 V2s'C oaLA-q E
Department of Emimnmenk Health and Natural Resources Sheet:
Division of Envifonmental Health )D:
On-Site Wastewater Section Lot Property
SOIUSM EVALUATION Fite
for ON-SITE WASTmAT>£>g.SYSmvt Code:
Owner. Applicant;
Addr+esa:.
Data Evacuated: \
PrOPMW Facility: 3 a t~ Desigtl 110 (.1949): 80 c~
P Size:
Lac9d0>1E ~ Site:
Pro ` , Iteoorded:
WatCt 9uppty;: Pubi~0 ❑ hidividual ❑ Well
❑ Spdng
Evattradan Mgthod:
Type dWastewater:
uger Boring ❑ Pit
S
❑ i
d
Chat.
ewage
n
ustrial Process
mixed.
P
R
O
P
1
1940
SOU. MORPHOWOY
OTHER
.
L ju rdeca
e H
i
.1941
P
ROFIt.B FA=
p
or
zaa
.1942
,
E Posidew DqA
a slope % (1a,)
.1941 .1941
Sail
sft
w
P
t 4~
cu
Considws welled
TeMupy Minereto Cater
9oii
1N
J4
i 0 4 5 <r , , ~rr~
.
❑ Other
1956 .1941 )!Irolltei
lope o Re* CIM
'tare Hollis. ALTAI:
Site C1awi8catian (.1948X 3
Evaluated By:
Others Prexnt: , 6