IPAC RRHTEOX SCI 13a) (Z(Z
Harnett County Department of Public Health 2 5 5 1 4
Improvement Permit p'-1-"P' J + f~eJ
A building permit cannot be issued with only an Improvement Permit ~w
PROPERTY LOCATION: I
ISSUED T0: ~ ~(fMM,vVf/ SUBDIVISION tA j,) 11i, /Z L LOT
NEV~4 REPAIR ❑ XPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: 6 - 5X 2- (Z„
Proposed Wastewater System Type: . P t _c t
Projected Daily Flow: 5(4D GPD
Number of bedrooms: 3 Number of Occupants: (ill, max
Basement ❑Yes 'V No
Pump Required: ❑Yes ❑ No
(
Type of Watei ppl : okxm
Permit conditiS7 c rk 'LMay be r
equired based on final location and elevations of facilities
, ;9- Public ❑ Well Distance from well ( Z~~ feet
Permit valid for:
❑ Five years
❑ No expiration
Authorized State Agent: LQS Date: C7 . 22 -J 17 SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health 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 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: ti n' um Al rv✓ PROPERTY LOCATION:
OSUBDIVISION 1,/0, 641 Z
Facility Type: .50 - 53"x s7 2 - 3Q2- New ❑ Expansion ❑ Repair
Basement? ❑ Yes 2QNo Basement Fixtures? ❑ Yes ~No
Type of Wastewater System** S ~l~ • ~5~ 5 (Initial) Wastewater Flow: 6,3 GPD
(See note below, if applicable 64
rT / &kc---L«.-- J(Repair)
Installation Requirements/Conditions Number of trenches ( I
Septic Tank Size 000 gallons Exact length of each trench T_ 0 _ feet
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of: o -d q inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
Pump Requirements: ft. TDH vs. GPM
Conditions:
Trench Spa" in Feet on Center
Soil Cover: M inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
Aggregate Depth:
inches below pipe
inches above pipe
inches total
**If applicable: / understand the system type speciCed is different from the type specified on the application. / accept the specifications of this permit
Owner/Legal Representative Signature: Date:
TL:. f__.._,..:__ 11_
-.1 ,,,,1-1-1.- -.1- , a..~.... -1 pm.., p.ai, of Lite mrenueu use cnanges, ine construction nutnonzanon shall not be transferred when there is a change in ownership of the site. This
Lonstructron Authorization is subject to com rice 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: Date: 3
Construction Authorization Expiration Date: 01_
HTE# 0-1 g3ooRa- Permit # a? 5s-/ T
Harnett County Department of 1- ~iblic Health
site Sketcll
PROPERTY LOCATON: Z jam,
ISSUED T0: C~YZ~ t/~'1~^w > SUBDIVISION <iZf LOT #
Authorized State Agent: Date:
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