IPAC RHTE# 03 $ Harnett County Department of Public Health 2 4 4 6 5
Improvement Permit
PROPERTY LO(AT ON: Z S
ISSUED TO: _ k_c01)n f~ ~i~rh m h as S usontuicinu 1.
ter" r r ~i i zc T_ LOT # J(,
NEW REPACK E3 EXPAN ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: _5 0 - 5 7 X /e -3 CZ~t
Proposed Wastewater System Type: Sl, _I{-; ,}~ls~
Projected Daily Flow: (o 0 GPD /
Number of bedrooms:. 3 Number of Occupants: -max
Basement ❑Yes 0 No
Pump Required: ❑Yes ❑ No May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community ~Z' Public Well Distance from well feet
-~Permit valid for: >0 Fire years
Permit conditions: (r) c L ~ n(1 t 1 cr'y A -A g c A\\ CC t t ~~C k S
❑ No expiration
L,( ~ lJl.lT t•.' I~ \k n - ,
Authorized State Agent: 2~ Date: 2- •J SEE ATTACHED SITE SKETCH
The issuance of this permit by the ealth 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
(Required for Building Permio
The construction and installation requirements of Rules .1 950, .1952, .1954. .1955, .1 9S6. .1957, .1958. 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 TO: { w tY~,.~~~,~ PROPERTY LOCATION: I Z 1
SUBDIVISION ~ ~ t ~ C_ LOT #
Facility Type: -Sr ?/Z- -J4 New ❑ Expansion ❑ Repair
Basement? ❑ Yes 1%--No Basement Fixtures? ❑ Yes )k~ No /
Type of Wastewater System" -a91, i'4,A f (Initial) Wastewater flow- ~tv ? GPD
(See note below, if applicable
A building permit cannot be issued with only an Improvement Permit
_9f"/, ~c~_t~,~^ Sa r f r~ (Repair)
InsUMon imuiranents/Coaditials
Septic Tank Size gallons
Pump Tank Size gallons
Pump Requirements: ft. TDN vs.
Conditions:
Exact length of each trench feet
Trenches shall be installed on contour at a
Maximum Trench Depth of: __U 4 inches
(Trench bottoms shall be level to +/-1/4"
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
"N applicable / undeatand the system type speciled it different from the type rpeciled on the applboon. / accept the ,pecilcations of this permit.
Owner/legal Representative Signature: _ Date:
This Construction Authoriution is subject to revocation if the site plan, plat, or the intended use changes. The constructon Authorin6an shall not be transferred when there is a change in ownership
of the site. This fonstruction Authorization is subject to compliance with the provisions of the laws and Rules (or Sewage Treatment and Disposal and to the conditant of'
this pertrdt
A
S SEE ATTACHED SITE SKETCH
Authorized State Agent: Date: 0
Construction Authorization Expiration Date: C~9 0 S - a0J3
HTE# ~9 i ~ Permit # 13?1 14 Ll 61-
Harnett County I ePallillent of hiblic Health
k~itc Sketch
PROPERTY LOCATON: I S^
ISSUED TO: _ (LCC1l~ c -r~ -5 SUBDIVISION ~3 S h , ►2 c- LOT #
Authorized State Agent AIL Date: - D
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