IPAC RHTE#_ j c t 551_gR Harhctt County Department of Public` ,ealth 23381
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
r` n PROPERTY LOCATION: l l
ISSUED T0: SUBDIVISION can t~ r LOT #
NEW, REPAIR ❑ EXPANSI ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: Or D ?.-0 tt Y~
t ,
Proposed Wastewater System Type: QS'X,
Projected Daily Flow: 3 J _GPD
Number of bedrooms: 3 Number of Occupants: G max
Basement ❑Yes `ld No
Pump Required: ❑Yes 'R -No §^y be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community ❑ Public ❑ Well Distance from well rU feet Permit valid for. five years
Permit conditions: ► (3 o-+- If t, bona 4, I)str, L-, J ywt.~. trT 41&3~.~ d 1, ,c/ a-- No expiration
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Authorized State Agent: L_~~~ K 1 Date: L D~- j $ a )J SEE ATTACHED SITE SKETCH
The issuance of this permit by 01 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 reroation 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
Reouired 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 actor ce tth the ttach system layout. ~pwz_~(
ISSUED T0: PROPERTY LOCATION:
SUBDIVISION 14, 111 LOT # *3 L
Facility Type: 0 New ❑ Expansion ❑ Repair
Basement? ❑ Yes t9- No BasemNJ- fixtures? ❑ Yes 1~'No
Type of Wastewater System" AY - (initial) Wastewater Flow: 3 GPD
(See note below, if applicable
U( M L- (Repair)
InsWa N lNghwettts/Condit im
Septic Tank Size 22 gallons Exact length of each trench 2'Z ) feet Trench Spacing feet on Center
Pump Tank Size gallonsTrenches_ shall be installed on contour at a Soil Cover. _ inches
Maximum Trench Depth of: N 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: It. TDH vs. GPM
Conditions:
Aggregate Depth:
inches below pipe
inches above pipe
inches total
**If applicable: / understand the system type specified is different from the type specified on the app/icanon. / accept the specifications of this permit.
Owner/Legal Representative Signature: Date:
This Construction Authorization is subject to revocation U the site oaan. plat or the intended use chanoes. The rnnctmctinn Authnrinrinn chill nnr ho tmdArrpA When thorn is , rhnnae in -norchin
of the site. This Construction Auth tat 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 Agent Date: 09 -\I ID I
Construction Authorization Expiration Date: 1)- 1- k-a31
HTE# V~JJ 15~ I! Permit # Harnett County Department of 1"liblic Health
Site Sketch
PROPERTY LOCATON. I
ISSUED TO: SUBDIVISION Cpl /,i, ,cA , I J LOT #
Autho 'zed State Agent: Date: K- a~ ,y
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