IPAC RHTE# a~~►~~~~~u2 Harnett County Department of Public Health 2 5 4 6 4
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: O-,-1
ISSUED TO: sA C-0 m(n G S SUBDIVISION M K1, s,C,- QIC.u 4,zic-L LOT # >
NEW` REPAIR ❑ XPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: S VD '~53:y
Proposed Wastewater System Type: ~Cicvv~t~ty t>\L
Projected Daily Flow: ~-k'L~ Q GPD
Number of bedrooms: L-) Number of Occupants: max
Basement ❑Yes ~K No
Pump Required: ❑Yes No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community ;X Public ❑ Well Distance from well S O feet Permit valid for. X Five years
Permit conditions: ❑ No expiration
Authorized State Agent:: Date: S ~-1 10C~ SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health 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, 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.
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 T0: PROPERTY LOCATION:
SUBDIVISION ~la~.~_ &-L,- R~ocC- LOT #
Facility Type: XNew ❑ Expansion -D Repair
Basement? ❑ Yes No Basement Fixtures? ❑ Yes X No
Type of Wastewater SysI Co" -V 0"-r -N ~ c1 r5 ~L (Initial) Wastewater Flow: LEV-) GPD
(See note below, if applicable
~GZ Uc"~ \0 f4 'S Yt, TE-m (Repair)
Installation Requirements/Conditions Number of trenches I.
Septic Tank Size S EOb0 gallons Exact length of each trench X.`70 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: '~fo 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: 111I.- inches total
*If applicable: /understand the system type specified is different from the type fpecilled on the application. / accept the fpeci6cationr of this permit.
Owner/legal Representative Signature: Date:
«I > - J- ic.-- we are prep, pray, of me mtenaeo use cnanges. me r.onstruaion authorization shall not be transferred when there is a change in ownership of the site. This
Construction Authorization is subject to compliance wi t ions a Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent: Date: 5 ~`f
Constr on Authorization Expiration Date:
HTE# Permit #
Harnett CvonntyT -Department of Public Health
Site sketch
PROPERTY LOCATON: 0 L-0 4a.~
ISSUED T0: ~.~rswt 5~~ cn r+F7 SUBDIVISION i' kn,E $F-LL ~~OCyE. LOT # 1
Authorized State Agent: vF ti ~z~c(~ Date: 51`7 0
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