IPACHTE# io--z31bi„ Harnett County Department of Public Health 2 57 1 3
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
t ' r PROPERTY LOCATION: Z7.6
ISSUED TOE rs CL K q_a" SUBDIVISION L ~c,r S LOT # to
NEW 2 REPA ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: b b U I
Proposed Wastewater System Type: Coyyt)e') ~
Projected Daily Flow: 3 GPD
Number of bedrooms: Number of Occupants: max
Basement ❑Yes No
Pump Required: ❑Yes ❑ No f/ Mae required based on final location and elevations of facilities
Type of Water Supply: ❑ Community L~f Public ❑ Well Distance from well feet Permit valid for: Z Five years
Permit conditions: ❑ No expiration
Authorized State Agen - Z /T /,N- Date: 7- - f a SEE ATTACHED SITE SKETCH
The issuance of this permit by theallth 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 Permit)
The construction and installation requirements of Rules .1950, .1952, .1954, .1955, .1956, .1951, .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: Pk~ ally Ck- 14ttfv-s S PROPERTY LOCATION: RWI, Z 7,e_
SUBDIVISION 5 J LOT
Facility Type: 0116 /uG New xpansion ❑ Repair
Basement? ❑ Yes No Basement Fixtures? El Yes No
Type of Wastewater System' C' {/g+M4)•. (Initial) Wastewater Flow: GPD
(See note below, if applicable
GA)1J00`' (Repair)
Installation Requirements/Conditions Number of trenches
Septic Tank Size / cr-q-0 gallons Exact length of each trench ! 00 feet
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of: 2q inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
Pump Requirements: ft. TDH vs. GPM
Conditions:
Trench Spacing: 2- Feet on Center
Soil Cover. 1~e inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
Aggregate Depth:
to inches below pipe
L inches above pipe
12 inches total
*If applicable: l ondecrtand the system type specified it di!lerent from the type specified an the application. / accept the rpec111'cationr of thin permit
Owner/Legal Representative Signature: Date:
" -.1- -.au- „ c pmu, plat, ui we intenueo use cnanges. the construction Authorization snau not he 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 Disoosal and to the conditions of this nprmit WF ATTAMM UTF WFUR
Authorized State Age Date: 29 - t D
Construction Authorization Expiration Date: f - f b
HTE# D-S - Z3j." Permit # .25-1 t3
Harnett County Department of Public Health
Site Sketch
PROPERTY LOCATON: ZZ
ISSUED TO: 1E74 _5 5 SUBDIVISION GJA-/ 5 yrt~a LOT # _
Authorized State Agenti: ~t zt GL Date: Z7 - /0
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Addm6: Date Evaillabed: / -Z -2
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