IPACHTE# Harnett County Department of Public Health
Improvement Permit 2 6 5 4 4
A building ermit Cann be issued with only an Improvement Permit
/Ml LOCATION:. O
ISSUED TO: r f .ae SUBDIVISION LOT #
NEW ❑ AIR ❑ EXP SION 13" Site Improvements required prior to Construction Authorization Issuance:
Type of Structure:
Proposed Wastewater System Type:
Projected Daily Flow: 366 ~ GPD
Number of bedrooms: Number of Occupants:'~max
Basement ❑Yes L~ No
Pump Required: ❑Yes ❑ Maybe required bas on final location and elevations of facilities
Type of Water Supply: ❑ Community E~ Public El" "Well Distance from well l°- ` feet Permit valid for: ® Five years
Permit conditions:
1 ❑ No expiration
Authorized State Ag Date: - j SEE ATTACHED SITE SKETCH
The issuance of this permit by e H alth Department in no way guarantees the issuance of other permits. The permit er is site is subject to revocation if a site plan, plat, or the intended use changes. The Improvement Permit shall not be affected byraschangeein ownership of the ste.pThsepermit isg bjectsto compliancehwith therprovisions hof
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 .1 950,
with the attached system layout.
.1952, .1 9S4, .1 95S,
.1956, .1951, .1958. and .1959 are incorporated by references
into this permit and shall be met. Systems shall be installed in accordance
ISSUED T0:
PROPERTY LOCATION:
Facility Type:
VISION
❑ New pansion ❑ Repair
/
LOT #
Basement? ❑ Yes No Basem
ent Fixtures? ❑Yes
No
Type of Wastewater System** -
C --s
(Initial) W
t
t
fl
(See note below, if applicable
as
ewa
er
ow: - GPD
(Repair)
Installation Requirements/Conditions
Number of trenches
Septic Tank Size gallons
Exact length of each trench feet
Trench Spacing: Feet on Center
Pump Tank Size gallons
Trenches shall be installed on contour at a
Soil Cover: inches
Maximum Trench Depth of. 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
Conditions:
'
Aggregate Depth: inches above pipe
Z
- 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: l understand the system type specified is different from the type speciled 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 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 Ag
Date:
Construction Authorization Expiration Date:
HTE# ZD Permit #
Harnett County Department of Public Health
Site Sketch
-51Z 1-5C- I tZ J n:. k (Z- S R 6