IPAC RRHTE# oa'S-aaA S3RSZ Harnett County Department of Public Health 2 5 3 3 3
lmnrovement Permit
A building permit cannot be issued with only an improvement Permit
PROPERTY LOCATION: 0 130,,SE-(L-1
ISSUED TO: ~t-c~c`~-w 61r1 \-)Lc, r,rc,S ~1-4 C- SUBDIVISION \rJcx3 lN4,r-~. LOT # _
NEW :P~v REPAIR ❑l EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: C 0 L.%J (L,,t" AL,0'
Proposed Wastewater System T pe: Co ~-4 Err; ~o t, L,
Projected Daily Flow: L-44 0 GPD
Number of bedrooms: k Number of Occupants: max
Basement ❑Yes !~`f, No
Pump Required: ❑Yes ❑ No X May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community Public ❑ Well Distance from well 100 feet Permit valid for: Xive years
Permit conditions: ❑ No expiration
Authorized State Agent: Date: C?~f_ SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the issuance permits. The permit holder is resp osible 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 it 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: $t-A[~~-~►~LL ~~of•nEg `~G PROPERTY LOCATION: Clz:'i CZD
SUBDIVISION LOT # 1` _
Facility Type: 5~fl ~`j~'L~1 X New ❑ Expansion ❑ Repair
Basement? ❑ Yes X No Basement Fixtures? ❑ Yes No
Type of Wastewater System** C0 t'i vE:r'T--' ~0 ri N- (Initial) Wastewater Flow: 470 GPD
(See note below, if applicable
'~-)o rc)~le P\Eouc,SsQ N' ~,er,n (Repair)
Installation Requirements/Conditions Number of trenches
Septic Tank Size JTD00 gallons Exact length of each trench a.~ feet Trench Spacing: Feet on Center
Pump Tank Size gallons Trenches shall be installed on contour at a Soil Cover: la inches
Maximum Trench Depth of: `mil inches (Maximum soil cover shall not exceed
(Trench bottoms shall be level to +1-I14" 36" above the trench bottom)
in all directions)
Pump Requirements: ft. TDH vs. GPM inches below pipe
Conditions:
Aggregate Depth:
ID- inches above pipe
-1k inches total
**If applicable: /understand the ,Ys stem type rpecifled it different from the type rpeci6ed on the app/nation. / accept the rpecifleationr of this permit.
Owner/legal Representative Signature: Date:
, „ o, , <v c.o a u < )'Po pen, piai, of um nnenaeu use cnanges. Ine lonSiruCUOn Rnmoraanon shau not he transterred when there is a change in ownership of the site. This
Construction Authorization is beet to cum the ions o laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit. SEE ATTACHED SITE SKETCH
Authorized State Agent: Date: 6 a'il 0
Con tion Authorization Expiration Date: ~ 2."r 1~
HTE# Q~5 -X~133Q1- Permit # 0'' 3
Harnett County Department of 1'i blic Health
Site Sketch
PROPERTY LOCATON: Nay e.p
ISSUED T0: SUBDIVISION W~osr~,~2E. LOT # 1q5
Authorized State Agent Date: I a
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