IPACHTE# IC-577a _ Harnett County Department of Public Health 2 5 8 9
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
ISSUED T0: l t' 1 ~~~cctyG~O S ~N PROPERTY LOCATION: (._EMUE.z.
SUBDIVISION (~**6 LOT # )ilkZS
NEW 4 REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure:
Proposed Wastewater System Type_ 0 N p
Projected Daily Flow: 0 GPD
Number of bedrooms: Number of Occupants: 6 max
Basement ❑Yes ANo
Pump Required: ❑Yes 1~ No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community X Public ❑ Well Distance from well 1~C] feet
Permit conditions: Permit valid for. Five years
Y A ❑ No expiration
Authorized State Agent::
Date: \D SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the is (e of other permits. The permit holder is responsi le 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 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 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 accordance
with the attached system layout.
ISSUED T0: ~oNS 2VL OCZ,c, INL PROPERTY LOCATION: Le-i y&L
SUBDIVISION ~50-fs t~, C)LOT # 1L}'C`
Facility Type: New ❑ Expansion ❑ Repair
Basement? ❑ Yes F], No Basement Fixtures? ❑ Yes X No
Type of Wastewater System** C-Z) I
(See note below, if applicable (Initial) Wastewater flow:O GPD
N J (Repair)
Installation Requirements/Conditions Number of trenches 1
Septic Tank Size t o00 gallons Exact length of each trench 1 5b feet Trench Spacing:
Pump Tank Size gallons ~ Feet on Center
Trenches shall be installed on contour at a Soil Cover: lc inches
Maximum Trench Depth of: _ } 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: ft. TDH vs. GPM
Conditions:
tea. L, Mvs (6 E
Vncse
~ X20 ~ 5
Aggregate Depth:
1G S ~S SEK1 - PC~LI 15T
=ms's. J L i 0~ j~
inches below pipe
inches above pipe
1 a inches total
**If aoolicable / understand the ryrtem type specified it different from the type specified on the app/ication. /accept the rpec1127tianr at thi permit.
Owner/Legal Representative Signature:
Date:
This construction Authoraatioo is subject to rev n if the si Ian, 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 s e to mmplian ith ~ isions~q he Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent: i>S
Date: tie,
truction Authorization Expiration Date: 1S
HTE# Permit # ~9
Harnett (Vount.y Depallnlent of I'liblic Health
it l 'Sketch
PROPERTY LOCATON: LE '-I ~ E.L Q-D
ISSUED TO: Co o ~NL SUBDIVISION C=c~cZC-sr 0-Por-5 LOT # 1~0
Authorized State Agent: Cyr Cps ~vCJL~bt Fsp(5[ir
Date: b
e
9
(l
~~tlNQL
l
th and Natural Reaour=
Division of of Eaviroamatt HMM Euvironn=W
On-Site Wastewater Seca
SOBAITZ &VALUATION
for ON-STT>c WASTLWATZR SYSTnj
Owner: Applicad: , 4
Addmm- Date Evacuated:
P
Location 0( roposed Facility: ~ g6beoe,n Design Fiw (.1949):
2f9 Waw
Water Snpplt Ply Reowded:
Shelt.
ty 1D:
Lot N:
File N:
Code:
Property Size:
Evahradan lrted,od: ❑ Indiviclud ❑ WeU ❑ Spring
Type of wueaatQ; gae ❑ ❑ac Ppit facess 1N1ired
2/8 b-, C,
1
lr7
site Claesi&4dan (.1948) :5
ETWumbd By
othen pled t
❑ other
pCLpPc~ a.L C~c-,n . u b2-4lPP _ z B 2 .