IPACHTE# oW:: Harnett County Department of Public Health 2 4 5 3 7
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION:
ISSUED TO: ~>`y OE. T ~bN SUBDIVISION QUQ;TO N LOT # _
NEW REPAIR ❑ EXPANSION Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: Maw , Ao rnE tai, rilrp'
Proposed Wastewater System Type:H lt~ o ~r ! _
Projected Daily flow: 3(n0 _ GPD
Number of bedrooms: Number of Occupants: C, max
Basement ❑Yes X No
Pump Required: ❑Yes ❑ No X May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community X Public ❑ Well Distance from well k60 feet
Permit conditions:
Permit valid for
Xfive years
❑ No expiration
Authorized State Agent:: ` ~945 Date: 31 ~j (R SEE ATTACHED SITE SIUCH
The issuance of this permit by the Health Department in no way guarani s the issuance of other permits. The permi 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 AM. .1952, .1954, AM, .1956, .1951, AM. and .1959 are incorporated by references into this permit and shall be met Systems shall be
installed in accordance with the at ched system layout
ISSUED TO: CLynE ocv PROPERTY LOCATION:
SUBDIVISION B v t N LOT # -5
Facility Type: MAt4 % nCC New ❑ Expansion ❑ Repair
Basement? ❑ Yes '54\ No Basement Fixtures? ❑ Yes X No
Type of Wastewater System" Co" V v') NI 'L (Initial) Wastewater Flow _6C ~ GPD
(See note below, if applicable
Cort.r s; tc~ssAL (Repair)
Instaklion RequhfxwnWConditions
`3 -s~.r,.,cMES
Septic Tank Size IQOU gallons Exact length of each trench ~d feet Trench Spacing 9 Feet on Center
Pump Tank Size gallons _ Trenches shall be installed_ on contour at a Soil -Lover:- 'I inches -
Maximum Trench Depth of: at'1 inches (Maximum soil cover shall not exceed
(Tren(h bottoms shall be level to +/-1/4" 36" above the trench bottom)
in all directions)
Pump Requirements: h. TDH vs. GPM inches below pipe
Aggregate Depth: a inches above pipe
Conditions: ~l inches total
"If applicable: / underrtand the ryatem type rpeci(ed it different from the type rpeciled on the application. / aaept the rpecitcations of thir permit
Owner/Legal Representative Signature: _ Date:
This Construction Authorization is subject to revoc the si an, plat, or the intended use changes. The Construction Authorization shall not be transferred when there is a change in ownership
of the site. This Construct Au matron is SUN co the provisions of the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit
" SEE ATTACHED S(fE SKETCH
Authorized Sta e~
to Agent 45 Date. 3
Construct, Authorjzation Expiration Date: 3 ti
HTE# Permit #
Harnett County I eparciltellt of I'liblic Health
Site Sketch
PROPERTY LOUTON:
ISSUED TO: C.L OE SUBDIVISION gv2Sa~v LOT # S
Authorized State Agent ` W~wCn 'soLrr~ Date:
yui
b
V
C
D_EPq;(L Ao-CK
OG ~,VAwaT~Ut~
I
a~4b