IPAC R (2)HTE# 0~-5-~ ls► 2, Harnett County Department of Public Health 2 5 6 9 4
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: La~ oll L' Q'PK.w ~
ISSUED T0: O Ey• ~``rG SUBDIVISION ,lzw6lT LOT # 5
NEW A REPAIR ❑ XPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: 4_07-*0 t''s66
Proposed Wastewater System Type: eu,Y e _C a 1S7d Q.6-4~i to M%%)
Projected Daily Flow: 3G O GPD
Number of bedrooms:- Number of Occupants: max
Basement ❑Yes No
Pump Required:-1511es 11 No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community '~J4 Public ❑ Well Distance from well \00 feet Permit valid for: Five years
Permit conditions: 4No expiration
Authorized State Agent:: Date: to( Gl c~ft SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the issuan f 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: Q~,,c~~ ,JGY• C-a ~C PROPERTY LOCATION: 1-~~nyG..t_ gLo,c~t
SUBDIVISION Q LOT # -S
Facility Type: S~OL6b'~6o~ New ❑ Expansion ❑ Repair
Basement? ❑ Yes '~R No Basement Fixtures? ❑ Yes ~No
Type of Wastewater System" Q c~-.eta a S""!o ik,6•o ucx ~ v,a 5 ytP', rn (Initial) Wastewater Flow: 3G C) GPD
(See note below, if applicable
fRannirl
Installation Requirements/Conditions
Septic Tank Size t o o c7 gallons
Pump Tank Size oo n gallons
Number of trenches L1
Exact length of each trench CoO feet
Trenches shall be installed on contour at a
Maximum Trench Depth of. 1 I inches
(Trench bottoms shall be level to +1-114"
Trench Spacing: Feet on Center
Soil (over: So inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
in all directions)
Pump Requirements: ft. TDH vs. GPM inches below pipe
Aggregate Depth: inches above pipe
Conditions: us tN c 5 , s c arc t'rae_t y ~Ert ~cP ~o o~ 1H ,-~,ta inches total
5~5>~.rt . 5~ ~P 8~~-~c~`i P~ C~`t6~6`1"'l ,,JD C3a~cWAt.._ p t~rr.,-~ ~rdct_1-o< "7 ~g60
**If applicable: /understand the ryrtem type rpeciTed it different from the type rpeci6ed on the application. /accept the rpeci6c3tionr of thir permit
Owner/Legal Representative Signature: Date:
This Construction Authorization is subfe vocation if thp 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 compli wi rov of the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent:
2.EH5 Date: 101C
Authorization Expiration Date: to es
HTE# Permit # o13,yv,0
Harnett County Department of Miblic Health
Site Sketch
PROPERTY LOCATON:
ISSUED T0: ~uESS pv SUBDIVISION Gc,~w~sC LOT #
Authorized State AgenC Date: 61
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