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HTE# 0°`l --S --~130C3 Harii tt County Department of Public nealth 2 5 7 6 4
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: ~JsLC l_vc~
ISSUED T0: S . L-nNt oo N G SUBDIVISION Q; t-, rs , 0 P, *,S. LOT # 4
NEWX REPAIR ❑ ~NSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: 5 ~ ~S3 x SS
Proposed Wastewater System Type: t d t4 ps L-.
Projected Daily Flow: L-A"%d GPD
Number of bedrooms: y Number of Occupants: max
Basement ❑Yes No
Pump Required: ❑Yes No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community Public ❑ Well Distance from well _ \O O feet Permit valid for Five years
Permit conditions: _ ❑ No expiration
Authorized State Agent: RC.hS Date: ti\ O~ SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the of other permits. The permit holder 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 Impr 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: G • S • IT". c-
Facility Type: S fl Qs3 Neff
Basement? ❑ Yes ~K No Basement Fixtures? ❑ Yes
Type of Wastewater System** C o N 14 ; C) N Q, t_,
(See note below, if applicable
PROPERTY LOCATION: \A -L-L- "C"C'.5 9-0
SUBDIVISION ";k i--,hj p. Pig LOT # 4 ~
❑ Expansion ❑ Repair
4No
(Initial) Wastewater Flow: Ll"8d GPD
C-o N v GJ'14-~,0 "r?,%.- (Repair)
Installation Requirements/Conditions Number of trenches
Septic Tank Size t on c7 gallons Exact length of each trench S O feet
Pump Tank Size gallons Trenches shali 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: l a-' ~ L',CC- In a
u -1 , L s (5 P" 'C'D-4
~ t_ SO you
O N l+v w,~ c
~C.. S~SiC-M
Trench Spacing:. Feet on Center
Soil Cover. \ ZL-a4 inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
inches below pipe
- CI Aggr ate Depth: a inches above pipe
Sa inches total
**If applicable: /under understand the system type specified is different from the type specified on the application. / accept the specifications of this permit
Owner/Legal Representative Signature: Date:
This Construction Authorization is s vocation if the site plan, plat, or the intended use changes. The Construction Authorization shall not be transferred when there is a rhanoe in nwnorchin of rho rim Thi,
Construction Authorization is subject to compliance) s o ws and Rules for Sewage Treatment and Disposal and to the conditions of this permit. SEE ATTACHED SITE SKETCH
Authorized State Agent: Date: v~ a d`t l / /t8tk 4
Construct) uthorization Expiration Date: a• 1K ltazR~ii
HTE# G"I-5-a3~3 Permit # AS-7(. D
Harnett County Department of Public Health
Site Sketch
PROPERTY LOCATON: W ~u- Lvc,A,s P.b
ISSUED TO: G. S• Z -P..~ cd~d,.~ Lev C r SUBDIVISION S' o r~~i t N p O a LOT #
Authorized State Agent Q_rg L"006 Date: 1\W 05
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