IPAC- for tank replacementHTE# c~a___~~~ Harnett County Department of Public Health 2 5 61 1
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
j PROPERTY LOCATION:--( S`1S`
ISSUED TO: r'' -mil YYrc SUBDIVISION LOT #
NEW ❑ EPAIV Q- XPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: ty„y~,P
Proposed Wastewater System T pe: S+
Projected Daily Flow: _ 3 GPD
Number of bedrooms: Number of Occupants: -max
Basement ❑Yes C}Ici
Pump Required: ❑Yes F}f No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community ID Public C}well Distance If om 11 -56 feet fi Permit valid for. 21ive years
Permit conditions: RQ 0Q.4 0 1 716 _VjILtkn r ❑ No expiration
Authorized State Agent:: Date: SEE ATTACHED SITE SKETCH
The issuance of this permit by t alth Departmen4no ar ntees a issuance 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, .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 TO: ~ f`~-✓` PROPERTY LOCATION:
SUBDIVISION LOT #
Facility Type: fJ- ❑ New Expansion @' Repair
Basement? ❑ Yes B'-Nci Baseme t Fixtures? ❑ Yes ❑ No
Type of Wastewater System** p7t S f Qt`s (Initial) Wastewater Flow: 360 GPD
(See note below, if applicable
(Repair)
Installation Requirements/Conditions Number of trenches 44
Septic Tank Size 000 gallons Exact length of each trench V,4 feet
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of. __44~inches
(Trench bottoms shall be level to +/-1/4°
in all directions)
Pump Requirements- ft. TDH vs. GPM
Conditions:
Trench Spacing: #4 Feet on Center
Soil Cover: _ AX . inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
Aggregate Depth:
--/4 Inches below pipe
NA inches above pipe
_ J1 . inches total
If applicable: /understand the system type specified is different from the type specifed on the app11&?#ofl / accept the spec&wions of this permit
Owner/Legal Representative Signature: Date:
This Construction Authorization is subject to revocation if the site plan, 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 subject to compliance with the provisions of the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent: .41
Date: t~ 9/0 x/v7
Construction Authorization Expiration Date:
HTE# Permit #
Harnett ('oullty I)epallnlent of Public Health
~~iteSketch
PROPERTY LOCATON:_ SY/5-
ISSUED TO: SUBDIVISION
LOT #
Authorized State Agent: Date: