IPAC RHTE# ~ "13f2 Harnett County Department of Public Health 2 4 4 6 2
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
ISSUED T0: ~~(~.fY~_ ~lbs5 PROPERTY lOCA110N:__ t~ ~tv\
SUBDIVISION ~\r-e~-- - LOT
NEWS REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: 2k~4 0~ ' X'A Z - &Z-
Proposed Wastewater System Type: U, c tr,r~,..~b ~
Projected Daily flow: ~~t0 GPD
Number of bedrooms: _=2 Number of Occupants: max
Basement ❑Yes No
Pump Required: ❑Yes ❑ No " -May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community El ublic Well Distance from well i0 c, feet
Permit valid for. ~ five years
Permit conditions: _V1 (a\\~Cl ~f fe 0 G'~Nskl~cs-
❑ No expiration
It I _
Authorized State Agent: Dace: SEE ATTACHED SffE SIM
The issuance of this permit by the alth Department in no way guarantees the usuance 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
(Required for Building Permit
The construction and installation requirements of Rules A950, .1952, .1954, .1955, 1956, .1957, .1 958, and .1959 are incorporated by references into this permit and shall be met. Systems shall be
installed in accordance with the attached system layout.
ISSUED T0: ~l~rti-. (1S s sA~ 2 PROPERTY LOCN: WC k 12-4
SUBDIVISION AT V~,4. LOT #
facility Type: l 11011-4 \ L _ Yit ~f 2 - New ❑ Expansion ❑ Repair
Basement? ❑ Yes Q No Basement fixtures? ❑ Yes -Al No
Type of Wastewater System" a~L/,de (Initial) Wastewater flow. :)2'10_ GPD
(See note bebw, if applicable)
d s (Repair)
Instathtiort Requirenettts/Condiiti~on
Septic Tank Size gallons
Pump Tank Size gallons
Pump Requirements: ft. TDH vs.
Conditions:
4
2wtek
Trench Spacing: feet on Center
Soil (over. C-
inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
inches below pipe
Aggregate Depth: inches above pipe
inches total
Exact length of each trench Y 'f-,Ij feet
Trenches shall be installed on contour at a
Maximum Trench Depth of: -12- inches
(Trench bottoms shall be level to +/.I/4"
in all directions)
GPM
"If applicable / andeatand the system type .rpeciFed is different from the type specified on the 7pp&,7#on. / accept the JpeciTcationc of thii permit.
Owner/Legal Representative Signature: _ Date:
This Construction Authorization is subject to revocation if the site an, plat, or the_intended_u_se changes. The Construction Authorization shall not be transferred when there is a change in ownership
of the site. This Construction Authoriza( 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: CJ 0 X SEE ATTACHED SITE SKETCH
Construction Authorization Expiration Date: Q L 0 5- 00 13
HTE # 0 2 5 00- ~(OY 3/L Permit # i y~ G '2
Harnett County Iep~ti-tniPnt of I_'~lbl is Health
Site Sketch
1 f~~ PROPERTY LOCATON:
ISSUED T0: SUBDIVISION li LOT #
Authorized State Agent: c,--~ Date: y
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