IPAC RHTE# Harkiett County Department of Public dealth 2 5 4 8 8
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: L twF~ $Llc,CW- Q-D
ISSUED T0: SUBDIVISION FEE C~ a.~ 9,3 LOT # VI L3
NEWN REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: `b
Proposed Wastewater System Type: - a5°lo (1{pvc, ,e~
Projected Daily Flow, Q ~$Q GPD
Number of bedrooms: ~ Number of Occupants: max
Basement ❑Yes X No
Pump Required: ❑Yes `4 No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community Public ❑ Well Distance from well feet Permit valid for Five years
Permit conditions: ~C~ ,Secs QEpcd p~ M 110 y S Ei ❑ No expiration
Authorized State Agent:: Date: SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the issuance of o its. 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 .19SO, .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:
PROPERTY LOCATION:
L-v--~ UC L ~ L G,,
SUBDIVISION (
) LOT # \-)IA
Facility Type: ~t t
New ❑ Expansion ❑
Repair
Basement? ❑ Yes IH, No Basement Fixtures? ❑ Yes 'tK No
Type of Wastewater System**
a5'Ls Qj u i d <,f
(Initial) Wastewater flow: ~)Q) GPD
(See note below, if applicable
~5°Lo
g~lJvycw ~ (Repair)
Installation Requirements/Conditions
Number of trenches
Septic Tank Size gallons
Exact length of each trench Sin
feet
Trench Spacing: Feet on Center
Pump Tank Size gallons
Trenches shall be installed on contour at a
Soil (over inches
Maximum Trench Depth of: N`~_
inches
(Maximum soil cover shall not exceed
(Trench bottoms shall be level to +/-1/4"
36" above the trench bottom)
in all directions)
Pump Requirements: h. TDH vs.
GPM
inches below
Conditions:
Aggregate Depth:
PIPe
inches above pipe
inches total
**If applicable: / understand the system type speci>ied rs different from the type specified on the app/iration. / accept the specifications of thin permit.
Owner/Legal Representative Signature: Date:
Tha a„ei.,,.,-;,,.,
11-1 - .11-1-- F,-, r^~ I'll 111-1-tu - uianxa. me iouxruwon aumonzanon snau not oe transterrea when there is a change in ownership of the site. This
Construction Authorization is subject to fiance wi the ons of ws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent: Date: D
Co n Authorization Expiration Date: l
HTE# Permit #
Harnett County 4*partment of Public Health
ite ketch
PROPERTY LOCATON:sw~~ ~vACw~~
ISSUED T0: ' 2ts~ ~02~ IN C . SUBDIVISION LOT # 1"1
Authorized State Agent: ~~~2ToLYs~4 Date: 4 m
3ti~
vn t1F 61x- arc-