IPAC RHTE# -S-0 - a o ~Har ett County Department of Public Health 2 5 3 5 5
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATIOE? y., U S
ISSUED TO: CA ~f,n~S ~cA SUBDIVISION Rc3-r pe, LOT # 09
NEW REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: S - >1 g - QIL.
Proposed Wastewater System Type: 0!
Projected Daily Flow: GPD y i,-)
Number of bedrooms: & L-r Number of Occupants: max
Basement ❑Yes ' WNo
Pump Required: ❑Yes ❑ No -,4May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community -9 Public ❑ Well Distance from well ~ J J feet Permit valid for. ~K Five years
Permit conditions: rn<t4 0^5 ~t .r.a\ 1^A es~~ sv~~ (-~:fl~ - k t} ❑ No expiration
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Authorized State Agent:: c t-50. f0 Date: 69 -c9(o -3 S 3 ti P 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 the site plan, pla( 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 taws 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: ctq ~l 1) PROPERTY LOCATION:
S p SUBDIVISION Clef 0ArC LOT # 1
Facility Type: S 3(3:~L cam.... New ❑ Expansion ❑ Repair
Basement? ❑ Yes No Basem nt FiTs
t ❑
Yes ~ No --y~-~8--~
Type of Wastewater System** S (Initial) Wastewater Flow: GPD
(See note below, if applicable
(Repair) Cale (3)oCk
Installation Requirements/(onditions Number of trenches )VD,
Septic Tank Size 1000 gallons Exact length of each trench ; 30 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. 18 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. TON vs. GPM inches below pipe
Aggregate Depth: inches above pipe
Conditions: inches total
**If applicable: / understand the system type specified is different from the type specified on the application. / accept the rpecifcationr 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
lonstruction Authorization is subject to c ce 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: a 0 3-:2)-'~: 5
Construction Authorization Expiration Date: u .o ate/
r 1
HTE# Permit # -s-S
Harnett Connty Depa lment of Public Health
Site Sketch
L PROPERTY LOCATON: t 1d
ISSUED T0: SUBDIVISIONS J7 c~( ~5 LOT
Authorized State Agent: CA, L-~&Z✓ Date: o?L- o~S
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