IPACHTE# C~-S-1G33~ Harnett County Department of Public Health 2 4 5 4 3
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
ISSUED TO: _ CC
-31 2ra:4
v.se^
V:~' P
PROPERTY LOCATION: At G-p,rta,
SUBDIVISION C_~Qrz
~~r IoooS LOT #
NEW\v
REPAIR ❑
EXP. S' ION ❑
b
Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: _
IP' p
x"13
Proposed Wastewater
System Type:
C.eNVs,a.~iv
Projected Daily Flow:
440
- GPD
Number of bedrooms:
_
4
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:
❑ Commu
nity K Public ❑ Well
Distance from well J C0 C0 feet Permit valid for. Five years
Permit conditions:
_
❑ No expiration
Authorized State Agent: 2: Date: ~L / pK
SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarante 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 B 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, .19SS, .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: C..o city ~rACta ~ PROPERTY LOCATION: 'rAT ~a tJwN C,oov_ L 94>
SUBDIVISION C_yPU.Z':5~ Wno LOT # L
Facility Type: 5 ti O ~~3 X85% x New ❑ Expansion ❑ Repair
Basement? ❑ Yes V No Basement fixtures? ❑ Yes X No
Type of Wastewater System" C.o.4vc ~r\- t~->t.rn,L_ (Initial) Wastewater flow- 4YO GPD
(See note below, if applicable
`'P -P (Repair)
Inst Itequiraneftts/Cottdibiorn
5 t,a~..,CarvE,s
Septic Tank Size ►ooo gallons Exact length of each trench BO feet
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of., _ a inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
Pump Requirements: ft TDH vs. GPM
Trench Spacing: g Feet on Center
Soil Cover inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
inches below pipe
Aggregate Depth: a inches above pipe
Conditions: _ Qn o+i 10 ~r sYtAi ~c 0" ~ota_ ~i r.e S y5-«..i 'LAY d L V a inches total
"`If a icable: l andeatand the system type fpeciled is different from the type speciled on the application. l 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 (onstruction Authorization shall not be transferred when there is a change in ownership
of the site. This (onstruction Authorizati su 'ect t compliance with the provisions of the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit
SEE ATTACHED SITE SW U
Authorized State Agent. Date: 3 bg
Construction Authorization Expiration Date: 3 4 'L---
HTE# OS- 5 -1 013'*4
Permit # '~14 5 Lj 3
Harnett County I epa,lltirient of h1blis Health
Site, Sketch
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