IPAC RHTE#Of -'s--ZZ06V/Z Harnett County Department of Public Health 2 5 4 2 6
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION:, aYJ /(Z F_If., /?/-'N
ISSUED TQ/ Cf/1'f Sr [.~~cZ> SUBDIVISION AZ ) - .4~ 4- LOT # Z3
NEW 7 REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: .5 C_1~
Proposed Wastewater System Type: 2°lvtZf-- bVt TtrO
Projected Daily Flow: 3 (n O GPD
Number of bedrooms: Number of Occupants: c/,- max
Basement ❑Yes No
Pump Required: ❑Yes ❑ No L~~Ma required based on final location and elevations of facilities
Type of Water Supply: El Community I~ Public ❑ Well Distance from well feet Permit valid for. CST Five years
Permit conditions: ❑ No expiration
Authorized State Ag t: Date: chi'-/~ - o S SEE ATTACHED SITE SKETCH
The issuance of this permit by a ealth 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. This
site is subject to revocation if 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: ~.I ~,vs c ~z PROPERTY LOCATION: _V_
SU DIVISION i~ t LOT # 20
Facility Type: s ENew Expansion ❑ Repair
Basement? ❑ Yes No Basement Fixtures? ❑ Yes No
Type of Wastewater System" Z tZ4!~-b UQtZ,,f X) _ , S y4;r-, (Initial) Wastewater Flow: Ro Q GPD
(See note below, if applicable
P/,z,.rcMG /_0 21 /Z~J'1l ~T2e ~J (Repair)
Installation Requirements/Conditions Number of trenches Z
Septic Tank Size 1006 gallons
Pump Tank Size gallons
Pump Requirements: ft. TDH vs.
Conditions:
Exact length of each trench G 5 n feet
Trenches shall be installed on contour at a
Maximum Trench Depth of. '4 ~nches
(Trench bottoms shall be level to +/-1/4"
in all directions)
GPM
Trench Spacing: Feet on Center
Soil Cover: riches
(Maximum soil cover shall not exceed
36" above the trench bottom)
Aggregate Depth:
inches below pipe
Z inches above pipe
Z 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: Date:
a. t«. c oiauou 11 lift Mt pien, pra, or me mrenaea use cnaages. the construction Authorization shall not be transferred when there is a change in ownership of the site. This
N, MC 1
UU)CLL w -11Pumiie wnn me Pruvuions or me taws ana rcules tot sewage treatment and Disposal and to the conditions of this permit. Jtt AI IALHtU lilt SKEILH
Y
Authorized State Age X44-,-J~~ Date: 6
Construction Authorization Expiration Date: - /
HTE# Chi -S -ZZ~o~fQ Permit # Z5 7(,,
Harnett ("ounty Depai tment of J- ~tblic Health
Site Sketch
PROPERTY N. l7
ISSUED T0: C/~t.1 SUBDIVISION ~iD iot # Z5
Authorized State Ag ~ Date:
Z, I
~J
I
1330 r
~z
S2 1 G'1K- fLr, j2b .