IPACHTE# QC, - Y- ;Z3-7 07 Harnett County Department of Public Health 2 5 8 3 6
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: ~7 des
ISSUED TO- c ~c ~ rE SUBDIVISION 7-;'l LOT # JZ
NEW REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: iC k5 -u
Proposed Wastewater System Type: Ivv r e,a
Projected Daily Flow: -7 C3 _ GPD
Number of bedrooms: -Z Number of Occupants: max
;4lo
Basement ❑Yes r:;4.
Pump Required: ❑Yes ❑ No E M be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community Public ❑ Well Distance from well feet
Permit conditions:
Permit valid for
R Ftve years
❑ No expiration
Authorized State Agent:: Date: ~C/0 SEE ATTACHED SITE SKETCH
The issuance of this permit by the alth Department in 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 he met Systems shall be installed in accordance
with the attached system layout
ISSUED TO: PROPERTY LOCATION: - 2
SUBDIVISION 12 o- ~L4 C- LOT # 3
Facility Type: S~F New ❑ Expansion ❑ Repair
Basement? ❑ Yes fff No Basement Fixtures? ❑ Yes ❑ No
Type of Wastewater System** 2-r7, . 1) -N r~~ (Initial) Wastewater Flow: GPD
(See note below, if applicable
j2~d us r (Repair)
Installation Requirements/Conditions Number of trenches
Septic Tank Size 06 C) gallons Exact length of each trench ~G feet
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of: inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
Pump Requirements: ft. TDH vs. GPM
s t h , ~(1 ~ j e ~ Ors CCA,J"'c ~fi f p-a k i
Trench Spacing: Feet on Center
Soil Cover: inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
Aggregate
G r f cj a,, r a
inches below pipe
inches above pipe
inches total
d-
If applicable: / #nderstand 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 change in ownership of the site. This
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 SEE ATTACHED SITE SKETCH
Authorized State Agent.//, &~yl pate: P"C/ c
V, -7, ~ Construction Authorization Expiration Date:
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