IPAC RHTE# o5" Harnett County Department of Public Health
hDrovement Permit 27037
Authorized State Age t:: g�' /d' Date: `2 — —/'7--- SEE ATTACHED SITE SKETCH
The issuance of this permit by th ealth 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 t ite 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..
A building permit cannot be issued with only an Improvement Permit
ISSUED TO:
PROPERTY LOCATION: .-
G- t" SUBDIVISION ' fitJA1 +-r
LOT # _
NEW
REPAIR ❑
EXPANSION ❑ Site Impro ements required prior to Construction Authorization Issuance:
Type of Structure:
1) L3MH
ISSUED TO: /r
Proposed Wastewater System Type:
PROPERTY LOCATION: 1532-
G+ vs t
Projected Daily Flow:
44 eL)
GPD
W 641 -' LOT #
Number of bedrooms:
��
Number of Occupants: max
Basement ❑Yes
L�I'No
Type of Wastewater System **
Pump Required: ❑Yes
❑ No
required based on final location and elevations of facilities
�
Type of Water Supply:
El Community
�Ma
Lfi Public El Well Distance from well feet Permit valid for:
2 ive years
Permit conditions:
4D jo t�-6� (Repair)
❑ No expiration
Authorized State Age t:: g�' /d' Date: `2 — —/'7--- SEE ATTACHED SITE SKETCH
The issuance of this permit by th ealth 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 t ite 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..
in all directions)
Pump Requirements: ft. TDH vs. GPM inches below pipe
Aggregate Depth: Z- inches above pipe
Conditions: 12— 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 sy tem type specified is di /ferent from the type specifed on the app lication. / 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 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 Agent. Date: % 7
Construction Authorization Expiration Date: `i °7 -/
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: /r
PROPERTY LOCATION: 1532-
G+ vs t
SUBDIVISION
W 641 -' LOT #
Facility Type: _
��
5KNew ❑ Expansion ❑ Repaif
Basement? ❑ Yes No
Basement Fixtures? ❑ Yes YNo
Type of Wastewater System **
2'S-%
I2 tiU G —V3 5-tl <15 � _= /Yf
(Initial) Wastewater Flow: 4100 GPD
(See note below, if applicable ❑)
PuL --V
4D jo t�-6� (Repair)
Installation Requirements /Conditions
Number of trenches q
Septic Tank Size / "Z(DQ
gallons
Exact length of each trench /00 feet
Trench Spacing: Feet on Center
Pump Tank Size
gallons
Trenches shall be installed on contour at a
Soil Cover: & inches
Maximum Trench Depth of: /r 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: Z- inches above pipe
Conditions: 12— 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 sy tem type specified is di /ferent from the type specifed on the app lication. / 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 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 Agent. Date: % 7
Construction Authorization Expiration Date: `i °7 -/
HTE# OT-57— 125-Z3iZ Permit # 2-7c,3
,14(arnett County Department of ll iblic Health
Site Sketch
PROPERTY LO CATON: JM1532 L#rOlc4l— leb
ISSUED TO: OC, Z- ?t Z SUBDIVISION b A-r4 L,4 W A+ LOT #
Authorized State Agent: e-`�� Date:
H
M
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