IPACHTE#&-- ~ z Harnett County Department of Public Health
Improvement Permit 2 6 8 3 9
A building permit cannot be issued with only an Improvement Permit
ISSUED TOr~G~ PROPERTY LOCATION: -ft
SUBDIVISION LOT #
NEW Z REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure:
Proposed Wastewater System Type: fZh4-\4-^-647/03
Projected Daily Flow: GPD
Number of bedrooms: Number of Occupants: G max
Basement ❑Yes No
Pump Required: ❑Yes ❑ No /May be required sed on final location and elevations of facilities
Type of Water Supply: ❑ Community El Public Well Distance from well 5-' feet Permit valid for. 2 /Five years
Permit conditions: ❑ No expiration
Authorized State rt:: Date: '.Z- SEE ATTACHED SITE SKETCH
The issuance of this perm. y 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, .1957, .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 TO: !z'tCZ,r",tsa PROPERTY LOCATION:
~ SUBDIVISION LOT #
Facility Type: !J New Expansion ❑ Repair
Basement? ❑ Yes Ej~ No Basement Fixtures? ❑ Yes E No
Type of Wastewater System" ZS% (Initial) Wastewater Flow: -3 GPD
(See note below, if applicable
2562, ►QZrO- 3 C,f2((-- 5+Ae, (Repair)
Installation Requirements/Conditions Number of trenche 2-
Septic Tank Size M06 gallons
Pump Tank Size gallons
Pump Requirements: ft. TDH vs.
Conditions:
Aggregate Depth: Z inches above pipe
2- inches total
WATER LINES (IN(LUDING 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 pecified on the application. /accept the rpecidcations 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 A Date: 12-
r Construction Authorization Expiration Date: Wit- 7
Exact length of each trench 15~-D feet Trench Spacing: 7 Feet on Center
Trenches shall be installed on contour at a Soil Cover: 4-- inches
Maximum Trench Depth of. 7.41 ) tS inches (Maximum soil cover shall not exceed
(Trench bottoms shall be level to +/-1/4" 36" above the trench bottom)
in all directions)
GPM inches below pipe
HTE# Permit # Z6 39
Harnett County Department of Public Health
Site Sketch
PROPERTY LOCATON:'UZ )?9/a-c z, -
ISSUED T0: SUBDIVISION LOT #
Authorized State ent: Date:
t2t~