IPACHTE# yci Harnett County Department of Public Health 2 5 8 7 8
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: Rvp1 r,E
ISSUED TO: ~Ers cy E-5~a cu M n-,.
SUBDIVISION S y mac,, LOT # IS
14
NEW REPAIR E3 WANSION El Site Improvements ~required prior to Construction Authorization Issuance:
Type of Structure: S FD
Proposed Wastewater System Type:
-c~+~+~tE,.t
Projected Daily flow: 36p GPD
Number of bedrooms: 3 Number of Occupants: max
Basement ❑Yes :~R No
Pump Required: ❑Yes ❑ No X May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community ';4, Public ❑ Well Distance from well
Permit conditions: -CXI) feet Permit valid for. Five years
❑ No expiration
Authorized State Agent:: I I
The issuance of this permit by the Health Department in no way guarantees a ce
site is subject to revocation if the site plan, plat, or the intended use changes. The Imp
the Laws and Rules for Sewage Treatment and Disposal and to conditions of this permit..
s Date: L6
SEE ATTACHED SITE SKETCH
of other permits. The permit holder is responsible for checking with appropriate governing bodies in meeting their requirements. This
vement Permit shall not be affected by a change in ownership of the site. This permit is subject to compliance with the provisions of
Construction Authorization
(Required for Building Permit)
The construction and installation requirements of Rules .195o, .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: (:,u (,,`\N~
PROPERTY LOCATION: 1ex Lip \ N ~
Facility Type: SFO L39 LI).0 SUBDIVISION 5 v M M s
New f-1 Expansion El Repair LOT # 151J_
Basement? ❑ Yes --N, No Basement Fixtures? ❑ Yes No
Type of Wastewater System** C0 r4v~r- N-ts sv P+U (See note below, If applicable (Initial) Wastewater Flow: 3~0 GPD
C6 w&4 : \ c, N N L (Repair)
Installation Requirements/Conditions Number of trenches 2l.
Septic Tank Size 1-0c 0 gallons Exact length of each trench feet
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of. s4- t." inches
(Trench bottoms shall be level to +/-I/4"
in all directions)
Pump Requirements: ft. tDH vs. GPM
Trench Spacing: Feet on Center
Soil Cover: )D, inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
Conditions: tea- SEP-vv5 r M Aggregate Depth:
inches below pipe
inches above pipe
_ inches total
**If applicable /understand the system type pecified is different from the type specified on the app/ication. / accept the Fpecif1c3t1ons of this permit.
Owner/Legal Representative Signature:
This Construction Authorization is subject to revocation if the site plan, plat; or the intended use changes. The Construction Authorization sha[I not be transferred when Date:
is a change. This
fonstruction Authorization is 111blect ce 'th visio of the Laws and Rules for Sewage Treatment and on and o the conditions of this ermit
Disposal p _ SEEownership
inATTACHEDthe
o1SITEsiteSKETCH
Authorized State Agent: Q'6~
Date: 91711-1
truction Authorization Expiration Date: -a tS'
HTE# 60 -S a36 c1
Permit # a
Harnett County Department of Permit
Health
Site Sketch
ISSUED T0: ' n N PROPERTY LOCATON: P~-9 imE
CU c~xY1 tN SUBDIVISION Sv
LOT # ► S L~_
Authorized State Agent: Qr--m ~o%A,;Grt
Date: a. 10
GvC)pI- rL L0erf
Dive o(EnviaM and Natwal RGSOUrcp Shed:
On-Site W Sew= Property ID:
Lot:
SOHJSITIC &VALUATION File :
for ON-grm BIAS Code:
TLWA'TILA SYSTZM
Owner. Applicant:
Addr m Date Evslmte& a.) ;),u
Prtipused Fac""r. 3 neo,~, Desna Flow (.1949): 360
Location of Site: ~~a'x p m► Recorded: 5f Prop" Sim:
Water Supply- AuM X60 Q Well
Evahsstion Mdhod: Pob~tc cut 13 Spring ❑ omen
'type Of Watewater; 13 Induce Proods ~ Mbmd
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1943 1 .19M
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