IPACHTE#Harnett County Department of Public Health 23591
Improvement Permit
A building permit cannot be issued with only an
PROPERTY LO(ATION-
ISSUED T0- t!rte ` t 1 c c~ i SU
NEW PAIR ❑ EXPANSION ❑
Type of Structure:~ystemT!ype: Proposed Wastewater to
Projected Daily flow: 3 G--,) _GPD
Number of bedrooms -Number of Occupants: --L-max
Basement ❑Yes A No
Pump Required'-Mes ❑ No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community Public ❑ Well Distance from well C-3 feet Permit valid for. ''Five years
Permit conditions: ;&C! f { 2 ❑ No expiration
1\ l1.
Authorized State Agent:: _ Date: Of yt . D K SEE ATTACHED SITE SOM
The issuance of this permit by t }Fealth Department in no way guarantees the issuance of other permits. The permit holder is responsible for checking
their with appropriate governing bodies in meeting
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, 1951, .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 }s ~tem la ouc
ISSUED TO: Qg, L ISri PROPERTY LOCATION: Gh,,r). I lntoa
SUBDIVISION I (sue Q 7A , , m s/~ ts, LOT # i-6-1
Facility Type: x s 1 -334 >j New ❑ Expansion ❑ Repair
Basement? ❑ Yes --;4 No Basement Fixtures? ❑ Yes J~r No
Type of Wastewater System`" ` (Initial) Wastewater Flow-~ GPD
(See note below, if applicable) -Tj'-`
tsita.. ,mac rrt-K LOT#
Site Improvements required prior to Construction Authorization Issuance:
Permit
J.J i-
I n~gR piramn Cond "^C (Repair)
iti~otts
Septic Tank Size gallons
Pump Tank Size gallons
Pump Requirements: ft. TDN vs.
Conditions.
Exact length of each trench _I A '3-3~> feet
Trenches shall be installed on contour at a
Maximum Trench Depth oLinches . 19 (Trench bottoms shall be level to +7-1/4"
in all directions)
GPM
Trench Spacing: f feet on Center
Soil Cover. C. inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
inches below pipe
Aggregate Depth: "2-- inches above pipe
I 'Z'_ inches total
-it applicable: / understand the system type specifed rs different from the type specified on the application l accept the specifications of this permit.
Owner/Legal Representative Signature: Date:
This Construction Authorintion is subject to revocation if the site plan, plat, or the intended use changes. The fonstntction Authorization shall not be transferred when there is a change in ownership
of the site. This fonstruction Authoritation is subject to compliance with the provsions of the laws and Rules for Sewage Treatment and Disposal and to the conditions of thk permit.
SEE ATTACHED SfFE SKETCH
Authorized State Agent: Date: Dl- I
Construction Authorization Expiration Date: ~7 T - y D
HTE# nI- - ft)'-) j
Permit #Sr J
Harnett Colultv I elwitluellt of Nblic Heaull
Site 'Sketch
PROPERTY LOUTON: C~II !n ( Q,
ISSUED TO: SUBDIVISION
4.1,.~'+ LOT # _f-~-~-
Authorized State Agent
Date: A DL ~ -3y
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