IPAC RRHTE#O`? -5=1(o2;,b'(2a Harnett County Department of Public Health
Improvement Permit 2 6 8 6 6
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: I-Q U 6 t- Gc
ISSUED TO: CIL-f,% c* ,-N - a rc.~5 SUBDIVISION LOT # V-~-
NEW LX REPAIR ❑ XPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: '57<D (
Proposed Wastewater System Type: plc v c.N'\d w y~ £r~
Projected Daily Flow: 3r-0 GPD
Number of bedrooms:
Basement ❑Yes
Pump Required: ❑Yes
Type of Water Supply,
Permit conditions:
Number of Occupants: max
No
X No ❑ May be required based on final location and elevations of facilities
® Community X Public ❑ Well Distance from well 1 (-*)0 feet
Authorized State Agent: Date: y►, ~a. SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the is k 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 Impro a 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: G._P.ca Or~~,s PROPERTY LOCATION: I- MV E- &-0,Qx.
SUBDIVISION Q4,-,G,,.,BS`' LOT # 1
Facility Type: 5q0 (t114 "36D New ❑ Expansion ❑ Repair
Basement? ❑ Yes 'K No Basement Fixtures? ❑ Yes "5< No
Type of Wastewater System** b-%-'Y- ZUCc s\ (I rvrt, (Initial) Wastewater Flow: GPD
(See note below, if applicable
E--f e (Repair)
Installation Require ments/(onditions Number of trenches D
Septic Tank Size t ® a v gallons
Pump Tank Size gallons
Pump Requirements: ft. TDH vs.
Conditions:
Permit valid for:
,X Five years
❑ No expiration
Exact length of each trench 21~3 0 feet
Trenches shall be installed on contour at a
Maximum Trench Depth of: IN 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 specired is different from the type speciled on the app/ication. / accept the specifications of this permit.
Owner/Legal Representativ ture, Date:
This Construction Authorization is subject to revocation i e plan, plat, 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 subjec fiance with the vis e ss ules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent: \ Rtr1 Date: 11141
Construct) A orization Expiration Date: L
HTE# C-iAWt..- Permit # ~O(C,
Harnett County ]Department of Rtbfic Health
Site Sketch
PROPERTY LOCATON:
ISSUED T0: g t \ sin 1~ ~.~f SUBDIVISION Ge, e was c LOT
Authorized State Agent: Qse~S Date: L 1
~ 3 c),
RQL-A I