IPAC RHTE# C j-A,--'- -14 ~ t iz Harnett County Department of Public Health 2 3 5 9 2
Improvement Permit
A building permit cannot be issued with only al ITnprovgmen Permit
PROPERTY LOCATION: 7
ISSUED T0: C' SUBDIVISION 1 s1N~: r}-c, LOT #
NEW-4 REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: S -
Proposed Wastewater System Type: 2- S't . xy A
Projected Daily Flow: 3 6 ~ GPD
Number of bedrooms: ______3Number of Occupants:_ __max
Basement Oyes )9Jto
Pump Required: OYes ❑ No `Nay be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community 11~ Public ❑ Well Distance from well c7 feet Permit valid for. "1'Five years
Permit conditions: .S 14A ck, el UM h,y, ,C~.q(~~y C S p) ~y~ le"', ❑ No expiration
n ---uL1 tsr t-% , v, l-~r
Authorized State Agent: - L -"y- ES Date, 0~ I Lo SEE ATTACKED SITE SKETCH
The issuance of this permit J(he alth Department in no way guarantees the issuance of other permits. The permit holder is responsible for checking with appropriate governing bodies in meeting
their requirements. This site 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, .19SS, .1956, .1957, AM. and AM are incorporated by references into this permit and shall be met. Systems shall be
installed in accordan with the attached s m layout.
ISSUED T0: PROPERTY LOCATION: n c
SUBDIVISION - A-s LOT #
facility Type: L H A 3 f- - 3 J2 O- New ❑ Expansion D Repair
Basement? ❑ Yes +,~(,No Basement Fixtures? ❑ Yes -4;eNo
Type of Wastewater System" - &2_ `p,/- s- It (Initial) Wastewater flow: (oJ GIRD
(See note below, if applicable fA
~-C (Repair)
Installation RequiretnelttslCtxtdifim
Septic Tank Size gallons
Pump Tank Size gallons
Pump Requirements: ft. TON vs.
Conditions:
Exact length of each trench feet
Trenches shall be installed on contour at a
Maximum Trench Depth of: I !ginches
(Trench bottoms shall be level to +/-1/4"
in all directions)
GPM
Trench Spacing Feet on Center
Soil Cover. _ Cainches
(Maximum soil cover shall not exceed
36" above the trench bottom)
inches below pipe
Aggregate Depth: inches above pipe
inches total
"If applicable 1 understand the system type specified is different from the type specified an the application. l accept the specifications of this permit.
Owner/Legal Representative Signature: Date:
This Construction Authoriution is subject to revocation d the 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 compliance with the provisions of the laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit
Authorized State Agent: ~ Date: 06- SEE ATTACHED SfTE SKETCH
Construction Authorization Expiration Date: y 1-16 - QD I
HTE# Permit # ,23~J Z
Hai'Ilott Comity Department of 1' 11)lic HPaltil
Site Sketch
PROPERTY LOCATON: f j( 6~
ISSUED T0: w SUBDIVISION
LOT #
Authorized State Agent: -
Date: 01- / (o-39
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