IPAC RHTE#900r--5-I ~Q- Harnett County Department of Public Health 2 5 3 3 8
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
t PROPERTY LOCATION: C-e eC vcsN s u F- Cxuaj~. 9.0
ISSUED TO: F^e.cn X L q IN v LSD rr>E N S S SUBDIVISION -,'S 09 U" O -,,66 LOT #
NEW'X REPAIR ❑ _XPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: SFO `lS X53
Proposed Wastewater System Type: -R,rne7a Cor,vGr,r, N cs N N, -
Projected Daily Flow: 490 GPD
Number of bedrooms: t-1 Number of Occupants: max
Basement ❑Yes ~4 No
Pump Requir4Xes ❑ No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community Public ❑ Well Distance from well l b b feet Permit valid for: Five years
Permit conditions: ❑ No expiration
Authorized State Agent:: --Z _ Date: IpCA SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the issua of other permits. The permit 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.
Construction Authorization
(Required for Building Permit)
The construction and installation requirements of Rules .1950, .1952, .1954, .1955, AS6, .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: Fyr.~.rty ~~.tyLnc N: PROPERTY LOCATION: C r4---y-svtu..C C-~,1vc1,C1A
Facility Type:
Basement? ❑ Yes -'4 No Basement F
Type of Wastewater System** Q u c-,p`~o
(See note below, if applicable
Pv MPF~o
Installation Requirements/Conditions
Septic Tank Size ►.ocoo gallons
Pump Tank Size ► y csO gallons
Pump Requirements ft. TDH vs.
Conditions:
SUBDIVISION "KILJu 0RYs LOT #
_ New ❑ Expansion ❑ Repair
ixtures? ❑ Yes X No
C-O" 'g C-"ys v d N Nt- (Initial) Wastewater Flow: LM GPD
`ZLs% Y~6ouGCsO N SyS M (Repair)
Number of trenches 1
Exact length of each trench 3aO feet
Trenches shall be installed on contour at a
Maximum Trench Depth of: inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
GPM
Trench Spacing: .'~'l_u Feet on Center
Soil Cover C~-)4, inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
inches below pipe
Aggregate Depth: ---L inches above pipe
k ~ inches total
**U applicable: /under tand the system type specited is dif/erent lrom the type specified on the app/icatian. /accept the specification of fhif permit.
Owner/Legal Representative Signature: Date:
This (nnctm iman lnth-i-6nn i, -hi-
• r ° g- 'nr -n-Uluu numunzauon snail not De transterrea when there is a change m ownership of the site. This
Construction Authorization is sk ct~to compliance wit(`the pry a Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent: A F2. Date:a~
Constru n Authorization Expiration Date: L -x13- 1A
HTE# Permit # a5'6-3s
Harnett ('onnty Department of I'nblic Health
Site Sketch
PROPERTY LOCATON: `~-~--y-sv%j-L(--
ISSUED T0: Fa cv.~ ~y `uv C-st crE H<S SUBDIVISION O i>" LOT #
Authorized State Agent Date:
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