IPAC RHTE# 1- 5 -30 �"1) Q, Harnett t art of lic Health
Improvement Per it
A building permit cannot be issued with only an Improvement Permit
�-^ PROPERTY LOCATION: cJ oG5p
ISSUED TO: 1 1-> q'Z- 1�°ScbUG•N rt SUBDIVISION (' LOT #
NEW'14 REPAIR ❑ _ 1EPANSION,[I Site Improvements required prior to Construction Authorization Issuance:
Type of Structure:
Proposed Wastewater System Type: -� °f° R6ovC_, <, yy S �gT�ct\
Projected Daily Flow: '-1`3 GPD
Number of bedrooms: LA Number of Occupants: max
Basement ❑Yes No
Pump Required: ❑Yes _,No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community '>f Public ❑ Well Distance from well t O0 feet Permit valid for: Five years
Permit condition ❑ No expiration
Authorized State Agent:: �5 Date: 14-1 1 SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way gu �pplato e issuance o f other permits. The permi holder is responsible for checking with appropriate governing bodies in meeting
their requirements. This site is subject to revocation if the site plan, e 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 he Laws and Rules for Sewage Treatment and Disposal and to conditions of this permit.
-4 .5&';� V.), '412,
t 1 1, i
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: )irl )A CpNx sayG-,soyy PROPERTY LOCATION: ®ocs
SUBDIVISION dP+�M b� LOT # 3J'
Facility Type: '� ��` �o f New ❑ Expansion ❑ Repair
Basement? ❑ Yes D No Basement Fixtures? LJ Yes No
Type of Wastewater System ** 0-50/6 (initial)
(See note below, if applicable ❑)
Installation uirements/Condipons
Septic Tank Size Z d® C'� gallons
Pump Tank Size gallons
Pump Requirements: ft. TDH vs.
Conditions:
Wastewater Flow: yq (3 GPD
_(Repair)
4 x 6p
Exact length of each trench feet
Trenches shall be installed on contour at a
Maximum Trench Depth of: S �" �.''� 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)
inches below pipe
Aggregate Depth: inches above pipe
inches total
* *If applicable: / understand the system type specified is different from the type specified on the app lication. / accept the specifications of this permit.
Owner /Legal Representative Signature
This Construction Authorization is subject to
of the site. This Construction'AWN nation is
Authorized State Agent:
Date:
site plan, plat, or the intended use changes. The Construction Authorization shall not be transferred when there is a change in ownership
o e with the provisions of the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit.
9_61�� Date: 1Q)
SEE ATTACHED SITE SKETCH
n uctjon Authorization Expiration Date: 17 �1
HTE #
Permit # %i
Harnett County Department of 11)lica �alth
Site Sketch
PROPERTY LOCATON: �c
ISSUED T0: ' �° rs c, �� as l SUBDIVISION LOT # 3
Authorized State Agent: oz- ,- 4G2 'TnLx. W Date: al Y-4-
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