IPACHTE# Harnett County Department of Public Health 2 591 7
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: Hw`]21O
ISSUED TO: M sc,~~c~£i- Q+4~ar~~+ SUBDIVISION a1~ ~~^•ca~ Po.~~ LOT #
NEW ❑ REPAIR ❑ EXPANSION Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: r-y--.cNL- e> u Q><rv
Proposed Wastewater System Type: E w ~t-s
Projected Daily Flow: 1GO GPD
Number of bedrooms: Number of Occupants: a E" Licrl 1-kx
Basement ❑Yes No i~~eaE~
Pump Required: ❑Yes V No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community >Q Public ❑ Well Distance from well lb0 feet Permit valid for: Five years
Permit conditions: ❑ No expiration
Authorized State Agent::
The issuance of this permit by the Health Department in no way guarantees the r ce
site is subject to revocation if the site plan, plat, or the intended use changes. The Imp
the Laws and Rules for Sewage Treatment and Disposal and to conditions of this permit..
Date: 3 { %I \,0 SEE ATTACHED SITE SKETCH
of other permits. The permit holder is responsible for checking with appropriate governing bodies in meeting their requirements. This
cement Permit shall not be affected by a change in ownership of the site. This permit is subject to compliance with the provisions of
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: M7Lze-,C-L- C~, of,
Facility Type: I?dbq'~- T` 5CcL- wN~-V-Q
Basement? ❑ Yes X No Basement Fixtures?
Type of Wastewater System**
(See note below, if applicable
Installation Requirements/Conditions
Sept[( Tank Size 10C)0 gallons
Pump Tank Size gallons
Number of trenches
Exact length of each trench
Trenches shall be installed on contour at a
Maximum Trench Depth of:
(Trench bottoms shall be level to +/-1/4"
in all directions)
(Initial) Wastewater Flow: GPD
feet Trench Spacing: Feet on Center
Soil Cover: inches
inches (Maximum soil cover shall not exceed
36" above the trench bottom)
Pump Requirements: ft. TDH vs. GPM inches below pipe
Aggregate Depth: inches above pipe
Conditions: ►a~naOGt~~ 'fat s~ a - -~vG ONLy NEJ--~•. PD51£- coI&'L\(-\n,L ~-inches total
5, ; Ql \3 a,-- D . -7+ y~ o '0 ss C -114 cc ~*V`C 6 U IL I' N ~r \ t;1.O . 1 kA 15 a" Ecz~ \ p\ ~ D 5 r O
p Die A E' f Q, Pt~H w,.t Lam(
**If applicable: / underrtand the ryuem type apeciled it different from the type .rpeclled ofl the app&dtion. / accept the rpecilcatioar of this permit
Owner/Legal Representative Signature: Date:
U LL-1 „u,,,o„i,uou ❑ wufeU ru ierueaUUu 0 me sire plan, plat, or me mtenaeo use cnanges. the construction Autnonzation shah not be transferred when there is a change in ownership of the site. This
construction Authorization is subject to co h rovisi f the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit. SEE ATTACHED SITE SKETCH
Authorized State Agent: ( Date: 314 N0
Constru ~ Authorization Expiration Date: tS'
❑ New
❑ Yes
PROPERTY LOCATION: N wy )~O
SUBDIVISION 2Ob Co r•ME2~~vt ~s~r2 LOT # W
Expansion ❑ Repair
No