IPACHTE# ""I, 10^1
Harnett County Department of Public Health 2 5 6 8 3
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: Yn-s• PvsGp,H G,vaca
ISSUED TO:S~ 1 ti -E~ ow N SUBDIVISION o E. LOT #
NEWX REPAIR yS^ EWNSION 11 Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: t"1 a O ~~C~r
Proposed Wastewater System Type: CONJE,-r-,Vz3";-C
Projected Daily Flow: GPD
Number of bedrooms: 3 Number of Occupants: max
Basement ❑Yes '~4No
Pump Required: ❑Yes P~ No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community 2~ Public ❑ Well Distance from well ki(~YO feet Permit valid for: Five years
Permit conditions: ❑ No expiration
Authorized State Agent:: ~5 Date: 9 )1 3Z) M SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the nce 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, .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: R\c~LZ-J
Facility Type: 'M.OCO QL k_7 6/ 'X1 New
Basement? ❑ Yes '>t No Basement Fixtures? ❑ Yes
Type of Wastewater System** Co > J vsrx sit
(See note below, if applicable
PROPERTY LOCATION: G,W ¢ca~,4
SUBDIVISION QN N 6£ LOT # 3
❑ Expansion ❑ Repair
_K No
(Initial) Wastewater Flow: 3~,0 GPD
Co NvE"r-< w N L' (Repair)
Installation Requirements/Conditions Number of trenches 3
Septic Tank Size Lo G 0 gallons Exact length of each trench N S O feet Trench Spacing: Feet on Center
Pump Tank Size gallons Trenches shall be installed on contour at a Soil Cover: 15; inches
Maximum Trench Depth of 4K 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 3a a inches below pipe
Aggregate Depth: a inches above pipe
Conditions: Wxv,;uz L-\.,Gt'\vst 10' Va~.e R, Sr~t~c S-yAr N o V-r,,.-\-s,~ t1~ r Sa inches total
C, «1011"5 .!t d vJ 4\T\ L CKY ,p-ERA\a,,,A S.
**If applicable: / undeatand the ryltem type spewed it different from the type apeci6ed on the app&vion. / accept the .rpecifbvt nt of thin permit
Owner/legal Representative Signature: Date:
This Construction Authorization is subject ocation i 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 Authorizaton is subject to mlr+e ons of the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit. SEE ATTACHED SITE SKETCH
Authorized State Agent: aki5 Date: 9}A Z)q
onstruction Authorization Expiration Date: g)so~ty
HTE# O~ 5 Permit # a5 673
Harnett County Department of 1-~tbfic Health
Site sketch
ISSUED TO:
Authorized State Agent:
PROPERTY LOCATON: • PGA\~uc2[~ 1~
_ SUBDIVISION Qa P, IR o~ LOT # 3
ss QoL, ~rz "t o~ Opt t Date: g ~