IPACHTE# Harnett County Department of Public Health 2 5 9 0 1
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION:
ISSUED TO: %4 YN rs C125 N 2uc~ I p*-J SUBDIVISION 1mot oc•t r2 r., LOT #
NEW REPAIR ❑ MANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: '-IFC) CSb~ S o'
Proposed Wastewater System Type: Co,~.r ESC ~ o car ptit_
Projected Daily Flow: 36 b 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 Public ❑ Well Distance from well 100 feet Permit valid for A five years
Permit conditions: ❑ No expiration
Authorized State Agent.: Date: 2G 10 SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees nuance of other permits. The per it
m 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 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 TO: V~ `4,, 4 CAo" (7.U G-G 1 CG N
Facility Type: 5cy C q;-n U/ New
Basement? ❑ Yes No
Type of Wastewater System** _
(See note below, if applicable
Basement Fixtures? ❑ Yes
4tGrJt -
PROPERTY LOCATION: 1- -Oc
SUBDIVISION to, t~~~ ~r~,rtr, LOT # -,~3-.
❑ Expansion ❑ Repair
-,'t<No
(Initial) Wastewater Flow: ~O GPD
(:!C NY'cA4rt10 (A (Repair)
Installation Requirements/Conditions Number of trenches 3
Septic Tank Size 1 000 gallons Exact length of each trench \ )5" feet Trench Spacing: 9 Feet on Center
Pump Tank Size gallons Trenches shall be installed on contour at a Soil Cover: Sa inches
Maximum Trench Depth of. e•L} 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 inches below pipe
Aggregate Depth: a inches above pipe
Conditions: ~ tG S'YYE Q inches total
**If applicable: / underwnd the system type roecifed it different from the type ,rpeci6ed on the app/icatiom / accept the rpecifUtionr 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 change in ownership of the site. This
Construction Authorization is subject to to m±ane4...wlth the =N~ and Rules for Sewage Treatment and Disposal and to the conditions of this permit. SEE ATTACHED SITE SKETCH
Authorized State Agent: Date: til ~
Concoon Authorization Expiration Date: 14
HTE# I O` 5-a3-76-7 Permit # 2 S9(pl
Harnett County I)epartment of Public nealth
Site Sketch
PROPERTY LO(ATON: P~Occ3 Q0
ISSUED TO: j C--:T O SUBDIVISION V ~ o ~ t=~ LOT # 0~3
Authorized State Agent: `vN- Date: D
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