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IPAC RHTE# �-,�„-S-`a`'i33 Haiiiett County Department of Public dealth hDrovement Permit 27169 A building permit cannot be issued with only an Improvement Permi HO PROPERTY LOCATION: SNG0 P,Zo ISSUED TO: P='4 '4 r O M� SUBDIVISION V7�+2K1 S LOT # 5' NEW K REPAIR ❑ �XPANSION El Site Improvements required prior to Construction Authorization Issuance: Q 3 Type of Structure: S i' (5^3`446' Proposed Wastewater System Type: QU s*. P >> 0 Z S° o Projected Daily Flow: L GPD Number of bedrooms: 5 Number of Occupants: N4& 10 max Basement ❑Yes XNo Pump Required:Xes ❑ No May be required based on final location and elevations of facilities Type of Water Supply: El Public ❑ Well Distance from well l00 feet Permit valid for: Five years Permit conditions: ❑ No expiration Authorized State Agent:: : \\ \y��\, '��S Date: 10 I 'i SEE ATTACHED SITE SKETCH The issuance of this permit by the Health Department in no way guarantees the issu f 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 Improverntrit 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.. (1,e- -i vi 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: CJPaV�t�► �tocr .t' PROPERTY LOCATION: 'S )A V RQQ Q(.L _ SUBDIVISION 1L��t -P•� A2ms LOT # S Facility Type: 'S 4�ZQ Cs3 a New ❑ Expansion ❑ Repair Basement? ❑ Yes 1 bb 0 No Basement Fixtures. ❑Yes No Type of Wastewater System ** PV r,4 fia `�.S/6 V6SS 04 (Initial) Wastewater Flow: GPD (See note below, if applicable ❑) 0 M T111 t 5`t e?'6AUco�N0s,) (Repair) Installation Requirements /Conditions Number of trenches 3 Septic Tank Size 1.O o © gallons Exact length of each trench "§Q 100 feet Trench Spacing: Feet on Center Pump Tank Size v 0 Z) Q gallons Trenches shall be installed on contour at a Soil Cover: C. 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: inches total WATER LINES (INCLUDING IRRIGATION) MUST BE IOFT. 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 is different from the type specified on the application. / accept the specification of this permit. Owner /Legal Representative nature: Date: This Construction Authorization is subject to revoc ' if the sit Ian, 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 su � ei� compliance th ' bns a Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit. SEE ATTACHED SITE SKETCH Authorized State Agent: Date: 101 117 Cons 'on Authorization Expiration Date: '1,0 1-1 i7-7 HTE# Permit # x.°11 C,9 Harnett County Department of -�iblic Health Site Sketch