IPACHTE# O°\ 5 a.3t1Sb Harnett County Department of Public Health
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: N
ISSUED TO: ~aY.fl S1r1PsoN ~O^~~ . C o. SUBDIVISION
LOT #
NEW ❑ REPAIR ❑ EXPANSION Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: tiro- M v,s.r. wstoiN(. t::-. -ts-6 % o N
Proposed Wastewater System Type: E'v r-,f, 'So Cs".rF- K a N A L
Projected Daily Flow: Ac-W 150 GPD
Number of bedrooms: Number of Occupants: Ca max
Basement ❑Yes 7K, No
Pump Required:)es ❑ No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community Public ❑ Well Distance from well _M feet
Permit conditions: Qb C O wsL> $E \Ssv b a MGR 'co ,51~ lNyP\LL p'F'
Permit valid for Five years
❑ No expiration
Authorized State Agent: -Date: ~''l(e~ SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the ance of other permits. the permit holder is re ponsible 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: 0PNNc) 5`sr,9S5s>,t CrJpi--C.Co - PROPERTY LOCATION:
SUBDIVISION LOT #
Facility Type: LIWS~ Vf\-N . f6v'w\NG ~ ❑ New X Expansion ❑ Repair
Basement? ❑ Yes X No Basement Fixtures? ❑ Yes No
Type of Wastewater System** ANY ~~>r C'L (Pvme) (Initial) Wastewater Flow: SO GPD
(See note below, if applicable
Cs~rzvF,.rc.oNp,L QvM~)f (Repair)
Installation Requirements/Conditions Number of trenches t
Septic Tank Size co ov<~n141, gallons Exact length of each trench 90 feet Trench Spacing: c' Feet on Center
Pump Tank Size I C:<) Q) gallons Trenches shall be installed on contour at a Soil Cover: Va, inches
Maximum Trench Depth of. a_L4 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: ft. TDH vs. GPM inches below pipe
Aggregate Depth: inches above pipe
Conditions: 5Ee<~~Tarvs~ MUS< 6f- R-v Lacer 7C 5 F?idt gil \~f7tiry G, l~ GVa0_et't 'CRN
v_ inches total
GP")"- C16~ `~u~c 5G'T9R<L F\ J~r."Taa~ MVS-s gE PEA ,
**If applicable: l 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:
This Construction Authorization o revocation if thp~site plan, plat, or the intended use changes. The Construction Authorization shall not be transferred when there is a chanee in ownership of the site. This
Construction Authorization is subj!tQcomplian th tI s of the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit. SEE ATTACHED SITE SKETCH
25596
Authorized State Agent: Date: I?
struction Authorization Expiration Date:
HTE# Permit # a55 `)f,
Harnett County Department of Miblic Health
Sit(--- Sketch
PROPERTY LOCATON: NC--,AACa5
ISSUED T0: Co SUBDIVISION LOT #
Authorized State Agent &L-IN Etl---lrdLxSW Date: '~R