IPAC RHTE# n7--~-o-- ► a~root2 Harnett County Department of Public Health 2 4 4 6 6
Improvement Permit
A building permit cannot be issued with only a Im rovement Permit
PROPERTY LOCATION:_ _ 17 F
ISSUED T0: 9 F►' SUBDIVISION ._~~cJT pjtS LOT #
NEW REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: BR
Proposed Wastewater System Type:
Projected Daily Flow: ~k-'.} GPD
Number of bedrooms: _3Number of Occupants: 42 G max
Basement ❑Yes I kNo
Pump Required: ❑Yes ❑ No 'V~May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community ❑ Public ❑ Well Distance from well _ 0 _ feet Permit valid for. ❑ Five years
Permit conditions: o5%~
O'A A t? -tAr+ -erg r~~ ❑ No expiration
Authorized State Agent: r..- Date: ~c C) Y
The ATTACHED SITE SlfEitN
The issuance of this permit by t 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 ubject to revocation 4 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 .1950, 1952, .1954, .1955, .1956, AM, .1958. and .1959 are incorporated by references into this permit and shag be met. Systems shall be
installed in accordance with the attached system layout.
ISSUED TO: PROPERTY LOCATION-
g SUBDIVISION fl-e I % X) }t .S LOT #204
Facility Type: - LJ X4 '9 - ~Eiif ltew ❑ Expansion ❑ Repair
Basement? ❑ Yes No Basement fixtures? ❑ Yes kRNo
Type of Wastewater System" 01S2. (Initial) Wastewater flow: GPD
(See note below, if applicable
(Repair)
InslAlMoo Reguitmtents/Conditiofts
Septic Tank Size JQ90 _ gallons Exact length of each trench 22r feet Trench Spacing: Feet on Center
Pump Tank Size gallons Trenches shall be installed on contour at a Soil Cover. _ inches
Maximum Trench Depth of inches (Maximum soil cover shall not exceed
(Trench bottoms shall be level to +/_1/4" 36" above the trench bottom)
in all directions)
Pump Requirements: ft. TON vs. GPM
inches below pipe
Aggregate Depth: inches above pipe
Conditions:
inches total
'If a°tslicable: l undeatand the rystem twpe rpeciped it different from the type rpecifled on the applrcation. l accept the rpecilcationt 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 n a change in ownership
of the site. This Construction Authori 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: ✓ a , 0
(onstruction Authorization Expiration Date: G , 2 - Q y~
HTE# 07 5-D3- 196039- Permit # O?f ` b
Harnett Comity 11epai-tlrtelit of public Health
Site Sketch
PROPERTY LOCATOR: 112 c
ISSUED T0: SUBDIVISION F^J2ea ( k S LOT # - D19
Authorized State Agent Date: Ox
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