IPACI = Harnett County Department of Public Health
Improvement Permit 27004
A building permit cannot be issued with only an Improvement Pe;mjt
PROPERTY LOCATIO /
ISSUED T0: , SUBDIVISION ' LOT #
NEW REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure:
Proposed Wastewater System Type:
Projected Daily Flow: 1,20 GPD
Number of bedrooms: Za f Occupants: Amax
Basement ❑Yes No
Pump Required: ❑Yes ❑ No required based on final location and elevations of facilities
Type of Water Supply: ❑ Community ❑ Well Distance from well feet
Permit conditions:
Permit valid for. L'Five years
I_ ❑ No expiration
Authorized State Agen . < Z ' Date: -3 r - 1 -L SEE ATTACHED SITE SKETCH
The issuance of this permit by 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, .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 TO: PROPERTY LOCATIO /Z ` fir. /
f' SUBDIVISION LOT #
Facility Type: I~L) 1Z New ~~Expansion ❑ Repair
Basement? ❑ Yes Eg/ No Basement Fixtures? ❑ Yes 1 No
Type of Wastewater System** _ L1 tx _ (Initial) Wastewater Flow: -36 C~ GPD
(See note below, if applicable /,d/ (Repair)
Installation Requirements/Conditions Number of trenches Z
Septic Tank Size gallons Exact length of each trench /S-6 feet
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of: f 2-->l 9 inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
Pump Requirements: ft. TDH vs. GPM
Trench Spacing: -Z Feet on Center
Soil Cover: - 2 inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
_ inches below pipe
I Aggregate Depth: inches above pipe
Conditions: 6,r '4 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 specified 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 chance 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 r 4Z 2ty Date: ~5_- - r 2.
Construction Aut orization Expiration Date: - - t f
HTE# d Z 995-0 Permit # Z- 7 00
T
Harnett County Department of iblic Health
Site Sketch
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