IPAC RHTE# Cy=~ -s-a3yly Harnett County Department of Public Health 2 5 7 9 3
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: N ~ur,ErL t Psi
ISSUED T0: CP Y t y s La ry Q ~f=~Etx~c~~r i SUBDIVISION ~c~e.ts~ do~K S LOT # _ a3,-
NEW~ REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: S FD}~~ ~'~s~ ec
Proposed Wastewater System Type: ~.5~10nU~-~~~u SysSE>^
Projected Daily flow: '~4a GPD
Number of bedrooms: y Number of Occupants: max
Basement ❑Yes -X No
Pump Required: ❑Yes "N~No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community Public ❑ Well Distance from well t00 feet Permit valid for: X Five years
Permit conditions: ❑ No expiration
Authorized State Agent.: QScI
The issuance of this permit by the Health Department in no way guarantees then e
site is subject to revocation if the site plan, plat, or the intended use changes. The Imps
the Laws and Rules for Sewage Treatment and Disposal and to conditions of this permit..
Date: y I o 9 SEE ATTACHED SITE SKETCH
of other permits. The permit holder is resp sibfe for checking with appropriate governing bodies in meeting their requirements. This
1Pwent 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 .1950, .1952, 1954, A955, .1956, A957, .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 T0: -PcysKGsS I_g1-30 ~lEu 'c~bn1~ PROPERTY LOCATION: NO~seQz Y `VD
SUBDIVISION F'oc:cSC Q) LOT
Facility Type: New ❑ Expansion ❑ Repair
Basement? ❑ Yes 1 No Basement Fixtures? ❑ Yes )KNo
Type of Wastewater System' R6Ov<:5:-, L QN SyS Eta (Initial) Wastewater Flow: t-}$ b GPD
(See note below, if applicable
°1d Res,'J L-c.d 0 S-J S ,ic-, sn (Repair)
Installation Requirements/Conditions Number of trenches
Septic Tank Size L 0 6 c) gallons
Pump Tank Size gallons
Pump Requirements: ft. TDH vs.
Exact length of each trench Q.-7O feet
Trenches shall be installed on contour at a
Maximum Trench Depth of. ]`z inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
GPM
Trench Spacing: Feet on Center
Soil Cover: inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
Conditions: \4 Lx~ LAN = ~'1os : ~E ~2p r~ 55=,pTs C Aggregate Depth:
S ' s r-\
inches below pipe
inches above pipe
inches total
If applicable: /understand the ryrtem type specified it different from the type tpecilled on the app/ication, l accept the rpec1f1cationc of this permiC
Owner/legal Representative Signature: Date:
This Construction Authorization is subject to revocation ' site pI aQ, 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 sub t compliance w o o Laws and Roles for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent:
9-0~ s Date: f -0ZS1) 0`1
Authorization Expiration Date: t~
9y .sN t- 1 t b d~
HTE# 0-1"5 L-~1' Permit #
Harnett Count` Depailment of Public Health
site sketch
PROPERTY LOCATON: NuQxZ-2y
ISSUED TO: oooS~~~ ~ Cam- ~"Q:;- NZsZ*- SUBDIVISION V--ogGs;-C O A~ LOT # 1 _
Authorized State Agent: aS uv -7 ~kso0g-) Date: mt~C s