IPACHTE# Vd.-"'aALJ°S3 Harnett County Department of Public Health
Improvement Permit 27089
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: C-)OCLESs C_*~Vt-QA 9.9
ISSUED TO: Q..} 04-~ eN
I*a C' SUBDIVISION ~.-aP2C-56 9o,, to~E
LOT #
NEW ❑
REPAIR ❑
EXPANSION Site Improvements required prior to Construction Authorization Issuance:
Type of Structure:
S'FO lE~ ~5T 6
Proposed Wastewater S
ystem Type: X5"1. Eovc: N 4tl
Projected Daily Flow:
L41% O
GPD
Number of bedrooms:
1-►
Number of Occupants: ` max
Basement ❑Yes
>No
Pump Required:xyes
❑ No
❑ May be required based on final location and elevations of facilities
Type of Water Supply:
❑ Community
"K Public ❑ Well Distance from well IOCJ feet Permit valid for:
Five years
Permit conditions:
'ice
❑ No expiration
Authorized State Agent:: Qfa`t+S Date: ~ V SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the i 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 Impro nt 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 Authorizati
Reauired 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: D 'A y2,-o, ~N c. PROPERTY LOCATION: C-Iez ~ vQr-)-\
SUBDIVISION Q--)?Q6-S6 PoN S& LOT #
Facility Type: S50 ~4IN D ❑ New ~ Expansion ❑ Repair
Basement? ❑ Yes No Basement Fixtures? ❑ Yes ~ No
Type of Wastewater System** ~S°lo F1FAyc/s t o N sus ~Gm L~U' ~ (Initial) Wastewater Flow: y~ GPD
(See note below, if applicable
3»S °le Q-uwct►0 W C3v~V) (Repair)
Installation Requirements/Conditions Number of trenches y
Septic Tank Size Ea~~s-~ 1N 6 gallons Exact length of each trench 15 feet Trench Spacing: T Feet on Center
Pump Tank Size C>41 5-S)" G gallons Trenches shall be installed on contour at a Soil Cover: inches
Maximum Trench Depth of: G¢col: 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
Aggrega_te Depth: inches above pipe
(onditions: 8~» GO l a 711 P,, ~,'A _ C)V'(Ak L-~'~ G- • ~y6AgE Fein-, inches total
WATER LINES (INCLUDING IRRIGATION) MUST BE 10FT. 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 it different from the type specified on the application. /accept the specifications of this permit.
Owner/Legal Representative Signature: Date:
This Construction Authorization is subject cation if the site plan, plaP or the intended use changes. The Construction Authorization shall not be transferred when there is a change in ownership of the site. This
Construction Authorizatiosubiect to complie wig ravi~'f the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent: ~ -,*.5 Date: )~D,
Con*uction Authorization Expiration Date: 8 )ZI l7