IPACHTE# J0- 5= :?3" Harnett County Department of Public Health 2 5 71 2
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LO(ATION::: ! i f iZ6
ISSUED Tt A-P C e f> SUBDIVISION b0#JAl cm ='S LOT #q
NEW REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: /FA t-El'
e: 7 molts 2(hT
Proposed Wastewater SysteyNo
Projected Daily flow: 1) GPD
Number of bedrooms: Number of Occupants: max
Basement ❑Yes Pum
p Required: ❑Yes ❑ No 0 Maye required based on final location and elevations of facilities
Type of Water Supply: ❑ Community !d Public ❑ Well Distance from well feet Per it valid for.
Permit conditions: 4-p __~a-l• ,rj~~
21 Ejve years
❑ No expiration
Authorized State Agen Date:
SEE ATTACHED SITE SKETCH
The issuance of this permit by 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 taws 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, .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: F04-o cc S •Twi-.s PROPERTY LOCATION: 5,e PS-6 S E"betZK--ZeA Ot
SUBDIVISION 14-titz LOT #
Facility Type: 10 New ~d Expansion ❑ Repair
Basement? E] Yes No Basement fixtures? ❑ Yes Z No
Type of Wastewater System' 76 (Initial) Wastewater Flow: '4j'0 GPD
(See note below, if applicable
-LIZ (Repair)
Installation Requirements/Conditions Number of tr ches S_
Septic Tank Size 17-W gallons Exact length of each trench "7y 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:. 2q 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. TDH vs. GPM inches below pipe
Aggregate Depth: 22 inches above pipe
Conditions: 4-T`s rKee C) ~ `si T(' ice,-4.ccsY~ /Z-- inches total
**If applicable: / understand the system type specifed is different from the type peci lied on the application. / accept the specifications 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 A
Se Date: /-16 -/O
Construction Authorization Expiration Date: / -ze S-
NTE# /cry Z3(,o(,® Permit # Z 5 7 /
Harnett County Department of Public Health
Site Sketch
PROPERTY LOCATON:_-,W _I SSA i e,2~1C G4- t/
ISSUED T0: /L d SUBDIVISION j -YLOT
Authorized State Agent. Date: 1-2 -10
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Depamneat of Emvitonment, Health and Natural Resources
Division of Environmental Health
On-Site Wastewater Section
SOIIJSITE EVALUATION
for ON-SITE WASTEWATER SYSTEM
Owner: Applicant: z 3co&
Address: Date Evaluated: / -Z 2 7 k4
Proposed Facility: M t, Design Flow (.1949): t SO
I.ocation of Site: 1, Recorl,
Water Supply: PubW ❑ Well
Evaluiden Method: 9 Auger Boring ❑ Pit
❑
Type of Wastewater: ❑ Sewage ❑ Industrial Process
Shat:
Property ID:
Lot:
File
Code:
Property Size: /,ft -
❑ Spring ❑ Other
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