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IPAC RHTE# Id°5- Harnett tt C t art t of lic Health Improvement Permit A building permit cannot be issued with only an Improvement Per it PROPERTY LOCATION: �C.AGOC x ISSUED TO: -�NQ� �40S�t�� SUBDIVISION Lp,K� LOT # °�-� Q NEWK REPAIR ❑ , EXPANSION El Site Improvements required prior to Construction Authorization Issuance: Type of Structure: S F0 `5Z_: 3A Proposed Wastewater System Type: 9Um�`�� o Rea 'Ja; nor l 'S Projected Daily Flow: GPD Number of bedrooms: Number of Occupants: max Basement %Yes Pump RequirediKYes ❑ No ❑ May be required based on final location and elevations of facilities Type of Water Supply: ❑ Community 'r'l Public ❑ Well Distance from well FJ feet Permit conditions: Permit valid for: ,Five years ❑ No expiration Authorized State Agent:: ® ��s Date: SEE ATTACHED SITE SKETCH The issuance of this permit by the Health Department in no way guarantees ' suance of other permits. The per m 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. Reouired 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: PROPERTY LOCATION: SUBDIVISION U LOT # 2,1D Facility Type: SVC) Csa�,� New El Expansion El Repair Basement? 'V Yes El No Basement Fixtures? El Yes Ak No Type of Wastewater System" i?uq4 �o J4 40/t- 'CEzv�;,o Q (Initial) Wastewater Flow: �i� G GPD (See note below, if applicable ❑) m� (Repair) Installation Requirements/Conditions Septic Tank Size t®®© gallons Pump Tank Size t-Qn 0 gallons Pump Requirements: ft. TDH vs. Conditions: Exact length of each trench Sx' -ltd feet Trenches shall be installed on contour at a Maximum Trench Depth of: 1`8`5% inches (Trench bottoms shall be level to +/ -1/4" in all directions) GPM Trench Spacing: `� Feet on Center Soil Cover. inches (Maximum soil cover shall not exceed 36" above the trench bottom) Aggregate Depth: inches below pipe inches above pipe inches total *If applicable: l understand the system type speciped is different from the type specified on the applicatiom l accept the specilcations of this permit Owner /Legal RepreseffhV e This Construction Authorization is of the site. This Construct" Authorized State Agent: Date: the site plan, plat, or the intended use changes. The Construction Authorization shall not be transferred when there is a change in ownership nce with the provisions of the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit. SEE ATTACHED SITE SKETCH Date: struction Authorization Expiration Date: HTE# 10 Permit # a'a3 i3 Harnett County 1)eparfinent of Public He-rdth Site Sketch PROPERTY LOCATON: eac4c—\ , ISSUED TO: SUBDIVISION LOT # Authorized State Agent Date: 5'K L k)C6