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IPAC RHTE# of -S-a3i Harnett Lounty Department of Public Healtn 2 5 7 7 4 o ~ -S ~3a`a5 C a2~.~~ Improvement Permit A building permit cannot be issued with only an Improvement Permit PROPERTY LOCATION: H t t-ti r,P„,~ ISSUED T0: A,vcyp,u. t~ES~$~clx' CPsast,C SUBDIVISION LOT # NEW' REPAIR ❑ EXPANSI(3N~ ❑ Site Improvements required prior to Construction Authorization Issuance: Type of Structure: (APt A xag Proposed Wastewater System T e: Co s' rEc r No N DAL Projected Daily Flow: 3 GPD Number of bedrooms: '-s Number of Occupants: max Basement ❑Yes ;f No Pump Required: ❑Yes i< No ❑ May be required based on final location and elevations of facilities h Type of Water Supply: ❑ Community ❑ Public Well D$nce from well COd feet Permit valid for. Five years Permit conditions: Ex'Si'H Or o expiration Authorized State Agent:: The issuance of this permit by the Health Department in no way guarantees the ce site is subject to revocation it the site plan, plat, or the intended use changes. The Imp the Laws and Rules for Sewage Treatment and Disposal and to conditions of this permit. Date: y1~ S-t, ©SEE ATTACHED SITE SKETCH of other permits. The permit holder is responsible for checking with appropriate governing bodies in meeting their requirements. This cement Permit shall not be affected by a change in ownership of the site. This permit is subject to compliance with the provisions of Construction Authorization (Required for Building Permit) The construction and installation requirements of Rules .1950, .1951, .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: 0S>,k_>~ ~Fc21,~ESL<~ Cc151,1E PROPERTY LOCATION: HSt_LMA,,t GQ"~,L SUBDIVISION LOT # Facility Type: '00 sTE New ❑ Expansion ❑ Repair Basement? ❑ Yes No Basement Fixtures? ❑ Yes No Type of Wastewater System** (Initial) Wastewater Flow: GPD (See note below, if applicable C."-4 C=^'< 'o 0 vy, (Repair) Installation Requirements/Conditions Number of trenches a Septic Tank Size Z o O U gallons Exact length of each trench S feet Pump Tank Size gallons Trenches shall be installed on contour at a Maximum Trench Depth of: inches (Trench bottoms shall be level to +/-1/4" in all directions) Pump Requirements: ft. TDH vs. GPM Conditions: Trench Spacing: Feet on Center Soil Cover: 1a.-1 inches (Maximum soil cover shall not exceed 36" above the trench bottom) Aggregate Depth: ~o inches below pipe a inches above pipe S inches total **If applicable: /understand the system type specified is different from the type specified on the application. / accept the specifications of this permit Owner/Legal Riqtr esentative Signature: Date: This Construction Authorization is su revoca on 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 it complia ovist of the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit. SEE ATTACHED SITE SKETCH -Ipb Authorized State Agent: Date: ill v, 0`1 cj Pr/ y Con ction Authorization Expiration Date: ~S 1~1 f HTE# O°1--~5 a-31`b j ` o~'S-a3 $5 Permit # aS, -1 y ~ACZp,6E Harnett County IDeptulment of 11riblic Health Site sketch PROPERTY LOCATON: N Lt~r. C7.cu_r/C ISSUED TO: C--Mjz C- SUBDIVISION LOT # Authorized State Agent: QC~S o~a~ ~o~Y s~ Date: } 1 ► \ Oq ~~Q if d~~y a.-) ) 11 40 GCE ZA B 2 0 d 1< 2 G N LL' 'V IIiQ ocLAw I v %