IPAC RHTE# iv-s--4~73g Harnett County Department of Public Health 2 5 716
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY
ISSUED TK_ ~j 67 9w< Uhf) ~ LOCATION:
d _~_~UBDIVISION LOT #
NEW REPAIR El EX NSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: - F~
Proposed Wastewater System Type: 25 b /Z.G a ,5.71 n.')
Projected Daily flow: 3f.-0 GPD
Number of bedrooms: Number of Occupants: max
Basement ❑Yes I~ No
Pump Required: ❑Yes ❑ No
Type of Water Supply: ❑ Community
Permit conditions:
I~ Mae required based on final location and elevations of facilities
121' Public ❑ Well Distance from well feet
Permit valid for.
Lit Five years
❑ No expiration
Authorized State Ag C ~ a
Date: Z-2Z -tD SEE ATTACHED SITE SKETCH
The issuance of this permit b 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 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 .1950, .1952, .1954, .1955, .1956, .1951, .1958. and .1959 are incorporated by references into this permit and shall be met Systems shall be installed in
with the attached system layout accordance
ISSUED T0: /a lcs~ PROPERTY LOCATI N:iy Ste'
SUBDIVISION L~ -5 ~i o,G,3_ a LOT #
Facility Type: :5F►~ Ld New Expansion ❑ Repair
Basement? ❑ Yes No Basement Fixtures? ❑ Yes Ef No
Type of Wastewater System- 2 5%JZA--6u s _ (Initial) Wastewater flow: 3(20 GPD
(See note below, if applicable
25°/a t2_ (Repair)
Installation Requirements/Conditions Number of tre ches /
Septic Tank Size !Do y gallons Exact length of each trench ZYD feet Trench Spacing: '2 Feet on Center
Pump Tank Size gallons Trenches shall be installed on contour at a Soil (over inches
Maximum Trench- Depth of_zy 1g inches (-Maximum-soil cow shall not exceed
(Trench bottoms shall be level to +1-114" 36" above the tren h b
in all directions)
Pump Requirements: ft. TDH vs. GPM
Conditions:
c ottom)
Aggregate Depth:
inches below pipe
Z- inches above pipe
rZ inches total
**If applicable: /understand the system type specified is different from the type specified on the app/ication. / accept the specifications of this permit
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
Construction Authorization is subject to compliance with the provisions of the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit,
e in ownership of the site. This
SEE ATTACHED SITE SKETCH
Authorized State Age G
Date: Z -1
Construction Authorization Expiration Date: Z-ZZ is'
HTE# /o -,S- - Z3t<,7.m Permit # a 5 7 /
Ilarnett ('ou my I)eparlment of -M bli c Health
Site Sketch
PROPERTY LOCATON: SS-
ISSUED T0: f arye ~L n7 SUBDIVISION ~~x a E 5 Tti n l LOT #
Authorized State Ag S Date: Z- ZZ - /a
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