IPAC RHTE#0 9-5 k, aiviett County Department o PubliL Health 25330
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
)iC3TN F-5 PROPERTY LOCATION: W t~~ l vc,~+s
ISSUED TO: ~n+ v - SUBDIVISION C:✓, N C3 s~,~-S LOT # 55
NEW ;K REPA XPANSION El Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: S ~U ~5;~,: 1a.
Proposed Wastewater System Type: 5?ur1R %0 Cviv rG+t:,c,aPL
Projected Daily Flow: L GPD
Number of bedrooms: 3 Number of Occupants: max
Basement ❑Yes 'KNo
Pump Required:-)gyes ❑ No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community X Public ❑ Well Distance from well IOC) feet Permit valid for: Five years
Permit conditions: ❑ No expiration
Authorized State Agent:: es Date: C- P3 0
SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the iss t 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 Improv pent Permit shall not be affected by a change in owners
hip of the site. This permit is subject to compliance with the provisions of
the laws and Rules for Sewage T atment and Dig osal and to conditions o this p rmit
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. 4) ~,-I- C ?'W- c,
ISSUED TO: 91 Ps PROPERTY LOCATION:
SUBDIVISION C),,Q-oL).,Q.
x3a
5a
O ;,~5 LOT # 5~_
,
Facility Type: S~
ti~✓
- New ❑ Expansion ❑ Repair
Basement? ❑ Yes X No Basement Fixtures? ❑ Yes )~i( No
Type of Wastewater System** PuMe `Co C--,, NL
(Initial) Wastewater Flow: 3~6 GIRD
(See note below, if applicable
_
20 cr,2 10 C-0c~vGN:~0 r.rp,L (Repair)
Installation Requirements/Conditions Number of trenches
Septic Tank Size ► oa el gallons Exact length of each trench feet
Trench Spacing: Feet on Center
Pump Tank Size \ Q-Jz) 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
Aggregate Depth: inches above pipe
Conditions: G"r,'F (nov<1-s2. n35E.C- '6D 'Qo-S'.k s~,LL-V_
inches total
**If applicable: l understand the system type specified is different from the type specified on the application. l accept the specifications of this permit.
Owner/Legal Representative Signature: Date:
This Construction Authorization is subject-4G-reyocation if the site plan, plat, or the intended use changes. The Construction Authorization shall not he transferred when there is a change in ownership of the site. This
Construction Authorization is snhje t`to complianceof the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit. SEE ATTACHED SITE SKETCH
Authorized State Agent: Q-- Date:
~sC~ <s-, Co uction Authorization Expiration Date: r-
HTE# OC1-5-~-~146~ Permit # x`330
Harnett County epaAmenit of Niblie Health
Site Sketch
Q) G~.P~Lx- ®c" S PROPERTY LOCATON: ~ tLv L-vcAs
ISSUED TO:~ SUBDIVISION GP.2pt.~~+a~ Vo~~,S LOT # 5'1
Authorized State Agent:
Q
(,LxvCz IoLK`Ao Date: CI o3A
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