IPACHTE# ►o-S-~~-~ Harnett County Department of Public Health 2 5 8 9 6
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: Hwy
ISSUED TO: `ciL~c pmt ~oM~ScY1~"~1~ SUBDIVISION I sf-A ~,J Pov E LOT #
NEW;K REPAIR ❑ IPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: S cTJ ~s~xi'r~'
Proposed Wastewater System Type: _D.~o ~EOt-tit,, `Jyg-fE.
Projected Daily Flow: 'AGO GPD
Number of bedrooms: 3 Number of Occupants: max
Basement ❑Yes 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 1.00 feet Permit valid for. Five years
Permit conditions: ❑ No expiration
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Authorized State Agent:: Date: SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the suance of other permits. The permit hold is re ponsible 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, .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:,lr:(z-<~ 0,y0
PROPERTY LOCATION:
SUBDIVISION 1 s N LOT # 1 Y-
facility Type: 5~~5~,x l New ❑ Expansion ❑ Repair
Basement? ❑ Yes No Basement Fixtures? ❑ Yes No
Type of Wastewater System** 2.S3/- ~ oct~o t Sys ry (Initial) Wastewater Flow: GPD
(See note below, if applicable
2`e10 V-E!3UCnt0 a Sys i Ern (Repair)
Installation Requirements/Conditions Number of trenches 3
Septic Tank Size Wb010 gallons Exact length of each trench S feet Trench Spacing: Feet on Center
Pump Tank Size gallons Trenches 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: ft. TDH vs. GPM
Conditions: WP~strt._ LNtiG 1Aus-, ~E 1 ~aor. S
12>~--'5E0 C - QQ0 V65 sp, L, 1P L\<
inches below pipe
Aggregate Depth: inches above pipe
5 Ys~N..`~kt~s ~EcZ~, inches total
t i- C__1 -N-- I, Lfrw ~-r
**If applicable: / understand the System type rpeciled it different from the type foecrfled on the 3pp1100017. / accept the roeC1&',V10nr 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 chanoa In ~W~o h r o ae rti,
Construction Authorization is subject to compliancy rovisteg 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: a, L 1 o
Co ction Authorization Expiration Date:
HTE# 10 ~5~37 j
Harnett Connty
Permit # Q ,mil b
Depailment of ll blic Health
Site Sketch
PROPERTY LOCATON: N wy 3~
ISSUED T0:Q A SUBDIVISION , ~ ~E Po i s G LOT # S_
Authorized State Agent: ~ < 2>r~~d~ ~~Gn °Co~~scY?t
Date:
GDt-b COUC4 ~7
D Deputomm ~ HeW* and N Resourm
Sheet.
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