IPAC R if he does a 5 bedroomHTE#33.-Harnett County Department of Public Health
Imurovement Permit 2 7 0 8 4
A building permit cannot be issued with only an Improvement Permit
t PROPERTY LOCATION: C1(-
ISSUED T0: SUBDIVISION ~o~z.OtlrtA S~goN5 LOT # V e;~-_
NEW ❑ REPAIR ❑ 4 XPANSION Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: 5~--Q C
Proposed Wastewater System Type: as°Jo V E4)v G. )13 1-1 S75--, f vcN
Projected Daily Flow: (~iJ 0 GPD
Number of bedrooms: -S Number of Occupants: S max
Basement ❑Yes >!,No
Pump Required: ❑Yes No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: El Community )9 Public ❑ Well Distance from well IC)(~ feet Permit valid for: Five years
Permit conditions: ❑ No expiration
Authorized State Agent:: V rN-5 Date: 61)c-~, SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the issua her 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 Improveme mit 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: 1~E3 5 --'SA~P`y y-af2 PROPERTY LOCATION: ~C 'y- ).,.4 on
SUBDIVISION ~PfW 1-)aia SLP.5ot-5 LOT # _
Facility Type: SCQ ~x~s~ 1H ❑ New Expansion ❑ Repair
Basement? ❑ Yes No Basement Fixtures? ❑ Yes >,No
Type of Wastewater System** Q~70 Rmv GS.\Q Si5-vs- (Initial) Wastewater Flow: GPD
(See note below, if applicable
3..!S°L6 QfiAV G "U N (Repair)
Installation Require ments/Cond itions Number of trenches
Septic Tank Size vN sZCP gallons Exact length of each trench 4 feet Trench Spacing: Feet on Center
Pump Tank Size gallons Trenches shall be installed on contour at a Soil Cover: D-'4- inches
Maximum Trench Depth of: '?)6" 1'9 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
Conditions: Ee Vo vi a
C~G•r L, ,r E_ (,;5r-Q 5
-'N G L- tN L-
inches below pipe
Aggregate Depth: inches above pipe
l.a 0 inches total
WATER LINES (INCLUDING IRRIGATION) MUST BE LOFT. 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 speci>ied is different from the type speciTed on the application. / accept the specifications of this permit.
Owner/Legal Represen Si nature: Date:
This Construction Authorization is subject to re ' n if the ' e 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 suec`to complian e h smn the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent: Date:
Cons tion Authorization Expiration Date: =
HTE# 1 -°5
Permit # ~LnOS
R(arilett County Depal-tlnellt of lblic ealth
Site Sketch
PROPERTY LOCATON: 0'(.t °ypL)-.\Nuu>
ISSUED TO; 7Q,cn- Z--NS7*'~NWI1-de- SUBDIVISION C. CcCWL~,ao• `~gsdAS LOT #
Authorized State Agent: ~~-~d6t?- ~o1-Y~vCUM Date:
-5`aN V-' OZ-~ i 0 Ns
0
5t=-s e~..oo~-s,oac~.L ~oo0
e~N Q ¢.v ~ ^i'41r ~c~ 1.s ES
HARNETT COUNTY HEALTH DEPARTMENT 18116
~~t 212'1- ENVIRONMENTAL HEALTH SECTION
OPERATIONS Name: (owner) A)k^ Q-New Installation 1~' Septic Tank ❑ Repair
Property Location: SR# ~Ob , Nitrification Line ❑ Expansion
Subdivision Cp►1~~~''N~ karma n Lot #L Tax ID # Quadrant #
Contractor: Registration #
Basement with Plumbing: ❑ Garage: rif
Water Supply: ❑ Well Public ❑ Community
Distance From Well: ft.
Following are the specifications for the sewage disposal system on above captioned property.
Type of system: ❑ Conventional [Y Other 12-t G vp)
Size of tank: Septic Tank: gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of
ft. ditches ft. ditches N4 in.
Drainage Field ditches J_ of each ditch _L_
French Drain Required: Linear feet Date:
PERMIT NO. d9- k llv- Inspected by:
s(. vfa NIAP
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