IPACHTE#_C 7 - s- i 91J ~ Harnett County Department of Public Health 24150
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: Sk /I k9
ISSUED TO-
SUBDIVISION rc k
LOT # ;l _U_
NEW R/ R PAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure:
Proposed Wastewater System Type: -j4cc r
Projected Daily flow: 3('0 GPD
Number of bedrooms: Number of Occupants: --max
Basement ❑Yes fiNo
Pump Required: ❑Yes ❑ No IJJ~Na be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community Public ❑ Well Distance from well feet Permit valid for IE Five years
Permit conditions:
❑ No expiration
Authorized State Agent: c o r Date: P F SEE ATTKNED SFrE SEM
The issuance of this permit byte Health 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 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
Re uired for Building Permit)
The construction and installation requirements of Rules .1950, .1952, .1954, .19SS, .1956, .1951, .1955. and .1959 are incorporated by references into this permit and shah be met. Systems shall be
installed in accordance with the attached s stem layout
ISSUED TO: 3Q G Wo PROPERTY LOCATION: f 'l- /
F SUBDIVISION 'LQx.r 4,., k LOT #
Facility Type: S Fp G7 KS'-SF New ❑ Expansion ❑ Repair 12
Basement? ❑ Yes No asement Fixtures? ❑ Yes ❑ No
Type of Wastewater System' cc<~,<<~( Sy sf{~ (Initial) Wastewater Flow: 3(7 GPD
(See note below, if applicable /
~c cep t<cf (Repair)
Insta h6m AMuirem nWConditians
Septic Tank Size 000 gallons
Pump Tank Size gallons
Pump Requirements: ft. TDH vs.
r
ms: r -t S
Nod" =,►r
" If applicable:
Exact length of each trench /00 feet
Trenches shall be installed on contour at a
Maximum Trench Depth of:._[1_ inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
GPM
4 C c.n A.4- 11 2 •.t 54.-t t,,4 ox Ads' ic,.t
OA,A.
Trench Spacing. ci feet on Center
Soil Cover. G inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
inches below pipe
Aggregate Depth: inches above pipe
inches total
/ understand the system type speciled If difierent from the type rpeciled on the app/ication. / accept the speci6cationr of thin pemtit.
Owner/legal Representative Signature: Date:
This Construction Authorization is subject to revocation if 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 Authorizat n n subject to compliance with the provisions of the taws and Rules for Sewage Treatment and Disposal and to the conditions of this permit
c SEE ATTACHED SFTE NO
Authorized State Agen Date: o 2 c
Construction Authorization Expiration Date: Y z 3
HTE# ~~-S=IS+rJ"y
Harnett County
Permit # a 4 f ra
Department of Public Health
Site Sketch
PROPERTY LOCATON:_ S ! Y J
ISSUED TO: o n~ k- C Q e.. " I- Qe,-a SUBDIVISION ~oj.- I ..1~
LOT # aZ
Authorized State Agent:
Date: i 3 2 cod
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