IPAC RHTE# V 7 I Igo 3(?, Harnett County Department of Public Health 24651
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
ISSUED T0: PROPERTY LOCATION:
SUBDIVISION D(ZC LOT #
NEW' REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: .5F(-- %-A ,3 t3 fl`
Proposed Wastewater System Type: 2 J
Projected Daily Flow: GPD
Number of bedrooms:- Number of Occupants: L_max
Basement ❑Yes ')A-No
Pump Required: ❑Yes ❑ No `May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community ~,Qpblic ❑ Well D' stance from well J feet Permit valid for. five years
Permi conditions: ,~~tif eti fA-fi (llI U{YI ,L~t h/q1 j' ~q p A4 l f~c ( L~~ ~ ❑ No expiration
Authorized State Agen . L ~ Date: _6 2 -a ? SEE ATTACHED SITE SIIETp!
The issuance of this permit by a 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 subject to revoation if the site plan, pla( 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 .19SO, .1957, .1954, .19S5, AM, .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: _ _Col,) _ PROPERTY LOCATION: _I 121-
SUBDIVISION~(te 1 j-c J LOT # Q O7
facility Type: _.S F0 2) ELI 1 - 3 2~.-New ❑ Expansion ❑ Repair
Basement? ❑ Yes tf--NO Basement Fixtures? ❑ Yes -)Z No
Type of Wastewater System" (Initial) Wastewater flow: GIRD
(See note below, if applicable 9
In~l_ I~t ritetnenis/Conditions (Repair)
Septic Tank Size O O gallons Exact length of each trench feet
Pump Tank Size gallons Trenches shall be installed on contou at a
Maximum Trench Depth of inches
(Trench bottoms shall be level to +/_1/4"
in all directions)
Pump Requirements: ft. TDH vs. GPM
Conditions:
Trench Spacing. / Feet on Center
Soil Cover. ~nches
(Maximum soil cover shall not exceed
36" above the trench bottom)
inches below pipe
Aggregate Depth: inches above pipe
inches total
"'If applicable / undeatand the system type speciTed is drNerent from the type speciled on the application l accept the specifications of this penntt.
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 Authoriza subject to complianc with the provisions of the laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit
O SEE ATTACHED SITE SKETCH
Authorized State Agent: Date: o2.a1-() a'
(onstructjon Authorization Expiration Date: 0 9 X I • ,).91-3
HTE# 13~- - - Q (Z Permit # dy r
Harriett County Depailment of hiblic Health
Site Sketch
ISSUED T0: PROPERTY LOfATON: I ~
SUBDIVISION ._.ljr~2Rc'J-7 LOT # a7
Authorized State Agent: Date.
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