IPAC RHTE# 67 - S- /8118 R Harneu County Department of Public I4ectith 24219
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: S tZ- l76_7 iz C-0 t t C IC uKiu
ISSUED TO: SUBDIVISION wiv. - t LOT # i NEW REPAI ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: SAD
Proposed Wastewater System Type: Sr sr(j~_
Projected Daily Flow: 11$0 GPD T-
Number of bedrooms: If Number of Occupants: _ max
Basement ❑Yes of
Pump Required: ❑Yes ❑ No C31'ay be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community ter Public ❑ Well Distance from well feet Permit valid for. ld Five years
Permit conditions:
❑ No expiration
Authorized State Age • Date: -/y- o
I~tIED
The issuance of this permit to Health Department in I way guarantees the issuance of other permits. The permit holder is responsible for checking with appropriateATT
SEE govEeDmingEfT
SbodiesTC~SinII meeting
their requirements. This s' x subject to revocation d 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 .1958, .1951, .1 9S4, .1955. .1956, AM, .1958. and .1159 are incorporated by references into this permit and shall be met. Systems shall be
insulted in accordance with the attached system layout.
ISSUED TO: .11 f~v_••~.~ 51~.,~. PROPERTY LOCATION:
SUBDIVISION 1f'f^1~~~6*6:~Z LOT # _ LL-
facility Type: S~ 0 /'New Expansion ❑ Repair
Basement? ❑ Yes No Basement fixtures? ❑ Yes Ind No
Type of Wastewater System`* Z5"/~26W (Initial) Wastewater flow y9d GPD
(See note below, if applicable
7ZM&"0 J S (Repair)
1119dition Regnhmettts Wditians
Septic Tank Size 14o6 gallons
Pump Tank Size gallons
Pump Requirements: ft. TON vs.
Conditions:
3X
Exact length of each trench /-33 feet
Trenches shall be installed on contour at a
Maximum Trench Depth of, 'Z J _ inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
GPM
Trench Spacing: Feet on Center
Soil Cover
t% inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
Aggregate Depth:
inches below pipe
2 -
inches above pipe
1 inches total
-If -applicable l undeatand the Jyrtem type specified it different from the type speciled on the application. l accept the rpecilcatioar of this permit.
Owner/legal Representative Signature: Date:
This Constructiai Authorization is subject to revocation if the site plan, plat or the intended use changes. The Construction Authonzatian shall not be transfened when there u a change in ownership
of the site. This Construction Authorization is subject to compliance with the provisions of the taws and Rules for Sewage Treatment and Disposal and to the conditions of this it.
t SEE ATTACHED SITE SKETCH
Authorized State Age~rt~ ~4*t Date: 9-/Y,,157
/914p
Construction Authorization Expiration Date: -P -,V-
i~,
HTE# d 7-:;-- /R /Z Permit # at y Z / 9
Harnett County 1epartrrient of I'ilbl is Health
Site Sketch
ISSUED TO:
Authorized State
Date: / - / `1-d 8
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3K t33' t~'~~5•
PROPERTY LOCATON:.'W 3 ,PAD zitw /AK- T
- SUBDIVISION ,*.e. LOT #
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