IPAC RHTE# o I loo 7t2 Harnett County Department of Public Health 2 4 4 5 8
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERLY LOCATION: ) L ~ -
NEW T0: ~~V tS SUBDIVISION (2 E 5 J S LOT #
NEW L~f REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: - yC sZ - Q P~
Proposed Wastewater System Type:
Projected Daily flow: 3 L 0 GPD Y s re r-
Number of bedrooms: 3 Number of Occupants: max
Basement ❑Yes 't'~'No
Pump Required:15ks ❑ No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community fA Public ❑ Well Distance from well ) feet Permit valid for. $~five years
Permit conditions: p'--~ ti Mp A '-k~~ S 3~ k El No expiration
S f\A(~ , nl nn s s
Authorized State Agent: Date: SEE ATTKNED SITE SKETCH
The issuance of this permit by the flee thh 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 uir for_Buildinz Permit
The construction and installation requirements of Rules .1950, 1952, .1954, .1955, .1956, 1957, .1958. and .1959 are incorporated by references into this permit and shag be met. Systems shall be
installed in accord rice with the attached system layout
ISSUED T0: flu\~Z t j1t~ PROPERTY LOCATION:
~ X S Z - (3 SUBDIVISION a g-G 1 ,7 J n k S LOT #
Facility Type: New ❑ Expansion ❑ Repair
Basement? ❑ Yes No Basement Fixtures? ❑ Yes -114 No
Type of Wastewater System" ~ a 1- ; r & 0,4. (Initial) Wastewater flow: 3 L b GPD
(See note below, if applicable 'AP U 7 0`~ 5 c~. S S (Repair)
Inshh6on imuirements/Condi6ons
Septic Tank Size F D 0 gallons
Pump Tank Size 13 0 gallons
Pump Requirements: ft. TDH vs.
Conditions:
Exact length of each trench X J feet
Trenches shall be installed on co tour at a
Maximum Trench Depth of., _ inches
(Trench bottoms shall be level to +/-I/4"
in all directions)
GPM
Trench Spacing Feet on Center
Soil Cover. inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
Aggregate Depth:
inches below pipe
inches above pipe
inches total
"`!f applicable: / andeatand the system type pecified it different from the type fpeci6ed on the 3op11cmon. / accept the srpeciflcations of this permit
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 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
SEE ATTACHED SITE SKETCH
Authorized State Agent. Date: ( f - &I ~ =
Construction Authorization Expiration Date: i ~ ~ 1)013-
NTE# 0?-" 00 I ~)DWZ_ Permit #
HitirnPtt County Department of hiblic Health
Site Sketch
ISSUED T0: PROPERTY LOCATON: _
coU~y-"t SUBDIVISION rZ e J 7 0A r-S LOT #
Authorized State Agent: Date: y f ' o~
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