IPACHTE# i~- s_Z~I-V- Harnett County Department of Public Health 2 5 8 9 5
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: 'i-A wjy2 l
ISSUED T0: ~t~sEG~-K- s b g~•~11 SUBDIVISION i t t-Ac'f.r'~ Qas ~,,-V C. LOT # tit }
NEW REPAIR ❑ E NSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: 5 (y~; x5a
Proposed Wastewater System Type: X5°l6 ~cwcs~o SYS~n
Projected Daily Flow: 3j GPD
Number of bedrooms: Number of Occupants: ~a max
Basement ❑Yes >kNo
Pump Required: ❑Yes ❑ No May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community ;K Public ❑ Well Distance from well lCX--) feet Permit valid for: Five years
Permit conditions: ❑ No expiration
Authorized State Agent:: Date: Z, `NC7 SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the uance 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 I rovement 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 accordance
with the attached system layout.
ISSUED TO: P.~ rL~c.Q,N )A.(3
Facility Type: S R_'~) (`ka -iS;o ( New
Basement? ❑ Yes No Basement Fixtures? ❑ Yes No
Type of Wastewater System**°la Cvc3 ~o u S ys (Initial) Wastewater Flow:
(See note below, if applicable
3,~°l~ Rc~c f o cJ SYs SfrM (Repair)
Installation Requirements/Conditions Number of trenches 3
Septic Tank Size 100 c) gallons
Pump Tank Size gallons
Pump Requirements: ft. TDH vs.
Exact length of each trench _ S feet
Trenches shall be installed on contour at a
Maximum Trench Depth of ) ~8 inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
GPM
'36C> GPD
Trench Spacing: Feet on Center
Soil Cover: inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
inches below pipe
Aggregate Depth: inches above pipe
Conditions: %4ATEQ_ Mur ~vp~Y,SC~'K inches total
.VFW✓~ 0- l alpaOS `1 Q~L tG4 b 1 L Co )LGAMC
**If applicable: /understand the system type rpeciCed a different from the type specified on the application. / accept the Jpecidcationr of this permit
Owner/legal Representative Signature: Date:
> -J"' ...nu on we one plan, pear, of me mtenueo use cnanges. ine tonstrucnon autnonzanon shall not be transferred when there is a change in ownership of the site. This
Construction Authonzation is subject to compliance with the provision 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 o
Con ion Authorization Expiration Dater
PROPERTY LOCATION:wy t,J
SUBDIVISION \ tNGE"J Povh~E LOT # t»
❑ Expansion ❑ Repair
HTE# 1Permit #
Harnett County Department of ll lbli c Health
SitkA ketch
PROPERTY LO(ATON: " w-)
ISSUED TO: t7 c p ch~~~~ v> SUBDIVISION 1 N ~o, r LOT #
Authorized State Agent 10~J~v- Date: O
C~0~o C-0v2l
Division Health Natntai R~ovana Sheet: `
On-site WadM*W Secdom Pf+ aiy ID:
Lot
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for Olr-S1Ti WASTLWATtt SYS'lZltit Code:
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