IPAC RRHTE Q)RJ. Harnett County o art e t of Public health
Improvement er it
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: O acs
ISSUED TO: ��i-> CpZ�:bM a VCG:N '� N SUBDIVISION LOT # A3_
NEWN<1 REPAIR ❑ €#P\ANSION f , Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: �� c' S ,�J T " y
Proposed Wastewater System Type:'Z-S °fa Rhovc<s0 N
Projected Daily Flow: L %Q GPD
Number of bedrooms: L-N 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 '5Z Public ❑ Well Distance from well s 6 d feet Permit valid for: Five years
Permit conditions:_ ❑ No expiration
Authorized State Agent: � V.15M5 Date: 1-�,111a SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way gu e issuance of 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, plat, o 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.
62c �.�C3a �a;,l 1a. 9,E-N ,s 60 t ) s %) ) --�' r,
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: )rA )A �oNS av2U Gi s 0 PROPERTY LOCATION: ®oGS
SUBDIVISION OPT 0 LOT # 33
Facility Type: 5� �''°�/ t ^ New ❑ Expansion ❑ Repair
Basement? ❑ Yes lk No Basement Fixtures? O Yes 'f7f No
O
Type of Wastewater System" - `x.51, ��Au cr.'t a +Q (IN Initial ) �
Wastewater Flow: L GPD
(See note below, if applicable ❑) t
2�SOt o V -WVC;' 1V'0 N SASS C-n (Renair)
Installation quirements/Conditions
Septic Tank Size � (Z)CD C�1 gallons
Pump Tank Size gallons
Pump Requirements: ft. TDH vs.
Conditions:
14X Go
Exact length of each trench feet
Trenches shall be installed on contour at a
Maximum Trench Depth of: A- -.4,4 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 application. / accept the specifications of this permit.
Owner /Legal Representative Signature:
This Construction Authorization is subject to
of the site. This Construction'4*ike ization 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
i e 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: 1 a
Authorization Expiration Date: 1i
HTE# Permit # 2,Li3 g 1
H(arnett County I)epartment of hiblic Realth
Site Sketch
M-1,
6)5 O'l" L, tj
I
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