IPAC RHTE#(, ~S = l6/y/K Hari ett County Department of Public 'oealth 2 4 4 0 4
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION:.S Z/Vz
ISSUED TOi- SUBDIVISION -T
&~Ff`~U ~--5 LOT # _jJ_
NEW REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: S F D
Proposed Wastewater System Type: 511 126p Projected Daily flow: 3 L ~ GPD
Number of bedrooms: Number of Occupants: (v max
Basement ❑Yes No
Pump Required: ❑Yes ❑ No IMa be required based on final location and elevations of facilities
Type of Water Supply: El Community Public ❑ Well Distance from well feet Permit valid for. I~ Five years
Permit conditions: ❑ No expiration
Authorized State A t: Date: /Z SEE ATTACHED SITE SKETCH
The issuance of this per biy, e 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. Thi site bje ct 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, .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: 1D5S 6131711)Fi2-
PROPERTY LOCATION: S,Z~~ -Jv~frs)v>~n/>n-5
SUBDIVISION LOT #
Facility Type: 5~~i~ [?"New ❑ Expansion ❑ Repair
Basement? ❑ Yes I~No Basement Fixtures? ❑ Yes ❑lo
Type of Wastewater System" Z'/0 JA) .TrsA, ,,_..(Initial) Wastewater Flow: GPD
(See note below, if applicable
&'lll
InstaUaafion uirerwntstConditions
Septic Tank Size 1006 gallons
Pump Tank Size gallons
(Repair)
,q X
Exact length of each trench 0 feet Trench Spacing: Feet on Center
Trenches shall be installed on contour at a Soil Cover: iU inches
Maximum Trench Depth of: ZY' 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
Conditions:
6 inches below pipe
Aggregate Depth: inches above pipe
/oZ inches total
"If applicable: l understand the system type specified is different from the type spea6ed on the application. l accept the specifications of this permit.
Owner/Legal Representative Signature: Date:
ims construction Rumonzation is suofect to revocation it 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 Construction Authorization is subject to compliance with the provisions of the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit.
51 SEE ATTACHED SITE SKETCH
Authorized State Agee / Date: /--/l D
Construction Authorization Expiration Date: / Z-! /
HTE# Z~ ',5- 110611/Z Permit #
Harnett County I)eparltnient of hiblic Health
Site Sketch
PROPERTY LOCATON•/ G' 10
ISSUED TO: / N- ~~vT c ~S SUBDIVISION d~ J LOT # 1 _
Authorized State Age Date: / Z-// r~L„