IPACHTE# G7-~ I Ys' Harnett County Department of Public Health 2 4 5 5 4
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LO(ATION: a\\o.~c~ ,e~.
ISSUED TO;- KMAc- 1L 4-71, SUBDIVISION LOT # 16-
NEW F~ REPAIR O EXPANSION O Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: 6-tF 0 6-e )C6'1 _
Proposed Wastewater System Type: P~ ~z r4ccca (-*,l _
Projected Daily Flow: 3 60 GIRD
Number of bedrooms: 1-? Number of Occupants: To max
Basement OYess No
Pump Required: L4es ❑ No ❑ Ma be required based on final location and elevations of facilities -
Type of Water Supply: ❑ Community f~Public ❑ Well Distance from well feet Permit valid for. Fl- Five years
Permit conditions: ❑ No expiration
Authorized State Agent Date: -21111dy~ SEE ATTACHED SITE SKETCH
The issuance of this permi,~t e Healt Department in no way gua6ees 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 affeued 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. .1955, .1956, .1951..1958. and .1959 are incorporated by references into this pernsit and shall be met. Systems shall be
installed in accordancg with the attached syste layout.
ISSUED T0: K ,rtAG ~.aS c.v.c>~ <~i ~,1c PROPERTY LOTON:
SUBDIVISION Q«w.c ~cl
N u LOT # /S
Facility Type: SAD >t sa f~New ❑ Expansion ❑ Repair
Basement? ❑ Yes VNo Basement Fixtures? ❑ Yes ❑ No
Type of Wastewater System" 4a iq~C 'mac{ -(Initial) Wastewater Flow -7~1 ~ GPD
(See note below, if applicable ❑)p `
j" T~~ePd (Repair)
Insta nR geuettFetFts//tondidw
Septic Tank Size /000 gallons
Pump Tank Size f Q~ gallons
Pump Requirements: ft. TDH vs.
Conditions:
Exact length of each trench I X 7S- feet
Trenches shall be installed on contour at a
Maximum Trench Depth of: ~ inches
(Trench bottoms shall be level to +1-114"
in all directions)
GPM
Trench Spacing: 9 Feet on Center
Soil Cover. /02 inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
inches below pipe
Aggregate Depth: inches above pipe
inches total
'*If applicable: / underrtand the frrtem type specified is different from the type rpecifled on the applboon. / accept the rpeatcavont 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 a to the conditions of this permit
/ SEE ATTACHED SITE SKETCH
Authorized State Agent Zf nato. W V 2q'-f
Construction Authorization Expiration Date:.21'112 Iii
HTE# 6`7- - /W VS-
Harnett County Department of
Site Sketch
Permit #
Public Health
PROPERTY LOCATON: s C I a J~ .
ISSUED T0: LOT # /
SUBDIVISION :vim S" c
Authorized State Agent s=. j Date:
CO
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