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IPAC RHTE#o~-~ ~~s~~ 2 Hatifett County Department of Public dealth 25178 Improvement Permit A building permit cannot be issued with only an Improvement Permit PROPERTY LOCATION: O -12 '-1 a,1 ISSUED TO: ~t~t~vit (~~,2) U~`s2CV c~ SUBDIVISION Ros k~rRAt~ ~Ja E LOT # NEW REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance: Type of Structure: S yD Proposed Wastewater System Type: ~H-J E- f ~1 rtAvL. Projected Daily Flow: 36 b GPO Number of bedrooms: 3 Number of Occupants: 6 max Basement ❑Yes X No Pump Required: ❑Yes No ❑ May be required based on final location and elevations of facilities Type of Water Supply: ❑ Community Public ❑ Well Distance from well F 00 feet Permit valid for Five years Permit conditions: Q get 151~ n,,s V,,., Fact- "TH 6 kC~o It N or $-r u ❑ No expiration Authorized State Agent:: (Z_S Date: 1 (©°I SEE ATTACHED SITE SKETCH The issuance of this permit by the Health Department in no way guarantees the iss Zi.ce of other permits. The permit holder 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, .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: C-2 a-o v C tea) b y PROPERTY LOCATION: O vo 1~ 1 SUBDIVISION _ Ross ~e C'~a P E LOT # )114 Facility Type: SevC~s New ❑ Expansion ❑ Repair Basement? ❑ Yes No Basement Fixtures? ❑ Yes X No Type of Wastewater System" c l,' "-J &'J; , ci " AL_ (Initial) Wastewater Flow: GPD (See note below, if applicable bs,i A.L- (Repair) Installation Requirements/Conditions Number of trenches 3 Septic Tank Size tQC)0 gallons Exact length of each trench 5 D feet Pump Tank Size gallons Trenches shall be installed on contour at a Maximum Trench Depth of: 21~ b inches (Trench bottoms shall be level to +/-1/4" in all directions) Pump Requirements: ft. TDH vs. GPM ~Trench Spacing: Feet on Center Conditions: M ece X02. a C N s ~Tlc7~, 1 yFf~ 1 Soil Cover. 13 inches (Maximum soil cover shall not exceed 36" above the trench bottom) inches below pipe Aggregate Depth: inches above pipe f inches total *If applicable: /under understand the system type specified is different from the type specified on the app/icdtion. / accept the speci6catrons of this permit Owner/Legal Representative Signature: Date: This Construction Authorization is subje evocation if the site" 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 c~comphance~ri~ e itions of ws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH Authorized State Agent: Date: 1. e Cons ~On Authorization Expiration Date: HTE# Permit # i`7 $ Harnett County Department of 1- iiblic Health Site Sketch PROPERTY LOCATON: 0 - L- ISSUED T0: ~QOv- ~1y ~~~2~uF SUBDIVISION Rases C'1~ ~taE g«.p LOT # S"i Authorized State Agent: n -T oc~~soo Date: 3'j C-~3s Fot~. 5'S OfLpt C ~ ~Ut v C 8} 11i10~ 55~ ~2~ E i12