IPAC RHTE#-O--) -5-10 S"I'(Z Harnett County Department of Public Health
Improvement Permit 2 6 7 3 9
A building permit cannot be issued with only an Improvement Permit p
PROPERTY LOCATION: L- E My Ga.-
ISSUED TO: ~L Cl- tk2~~ YNp t"^e5 SUBDIVISION G A~~wCS'c LOT # a•6
NEWX REPAIR ❑ ~PANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
hb' x35"
Type of Structure: 'S V0
Proposed Wastewater System Type: ~S"~o (-~vvC~G ns y5s
Projected Daily Flow: GPD
Number of bedrooms: - Number of Occupants: max
Basement ❑Yes ';5< No
Pump Required: ❑Yes ❑ No X May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community, Public ❑ Well Distance from well !00 feet Permit valid for: X Five years
Permit conditions: r- ❑ No expiration
Authorized State Agent:: Date: 51 ' `a-1 11 SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the iss t 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 Improve ermit 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: ~s-a -ra.cL~- ~prr r;S PROPERTY LOCATION: L4&nyGZ
SUBDIVISION G 9~5&-A ~C LOT # a~
Facility Type: SAO C~O'x~ New ❑ Expansion ❑ Repair
Basement? ❑ Yes No Basement Fixtures? ❑ Yes No
Type of Wastewater System** a~'lo V~ EoyCr, (1 s~ ~Y 5 i ~s~ (Initial) Wastewater Flow: GPD
(See note below, if applicable
QUm47o ~-~nt~a ~nelt.~~c~s\I (Repair)
Installation Requirements/Conditions Number of trenches 1
Septic Tank Size X00 d gallons
Pump Tank Size gallons
Pump Requirements: ft. TDH vs.
Conditions:
Exact length of each trench X34 feet
Trenches shall be installed on contour at a
Maximum Trench Depth of. 11 inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
GPM
Trench Spacing: Feet on Center
Soil Cover: inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
inches below pipe
Aggregate Depth: inches above pipe
inches total
WATER LINES (INCLUDING IRRIGATION) MUST BE IOFT. 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 specified on the app/ication. / accept the specifications of this permit.
Owner/Legal Representative Signature: Date:
This Construction Authorization 11 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 comp ith the provisioltthe Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit. SEE ATTACHED SITE SKETCH
Authorized State Agent: 2-" Date:
ction Authorization Expiration Date:
H T E G--1 N ' Permit # ~l 3
Harnett County Department of Public Health
Site Sketch
ISSUED TO:
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PROPERTY LOCATON: L~--vv!l- $ i-Ac;- - b
Authorized State Agent:
SUBDIVISION GFISe:-, LOT #
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