IPACHTE# ►0-5 X00 Harnett County Department of Public Health
Improvement Permit
25920
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: M R,'
ISSUED T0:t-r.c.~cw ELL 1~OM~S \NC,, SUBDIVISION LOT # 41
NEW REPAIR EANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: S ~fl "C5 'c (op'
Proposed Wastewater System Type: ?u-f"-To Qoir VF.,. \oNNL.
Projected Daily Flow: GPD
Number of bedrooms: 3 Number of Occupants: fo max
Basement ❑Yes No
Pump Required: `des ❑ No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community X Public ❑ Well Distance from well l00 feet Permit valid for: 'Five years
Permit conditions: ❑ No expiration
Authorized State Agent: Date: 3 1161 Xd SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the isa 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 Improve 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, .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 T0: ~►-~c~wwFi~ - ~pc~•L-S `Nc' PROPERTY LOCATION: TnPQX4, 9.0
SUBDIVISION NwA EF - C~ LOT # _A9
Facility Type: S VSO C,60~n6C'>~ New ❑ Expansion ❑ Repair
Basement? ❑ Yes ~K No Basement Fixtures? ❑ Yes XNo
Type of Wastewater System** Q v rn e `1 0 CX I-' o A
(Initial) Wastewater Flow: 3~ 4 GPD
(See note below, if applicable
py M?~o C an, ~Gr., S ~o NI (Repair)
Installation Requirements/Conditions Number of trenches 3
Septic Tank Size ► O00 gallons Exact length of each trench S
Pump Tank Size t b60 gallons Trenches shall be installed on contour at a
Maximum Trench Depth of. '3-<!) -3
(Trench bottoms shall be level to +/-1/4"
in all directions)
Pump Requirements: ft. TDH vs. GPM
feet Trench Spacing: Feet on Center
Soil Cover: S inches
inches (Maximum soil cover shall not exceed
36" above the trench bottom)
Conditions: "-4 K- Fes-- Li aY-' vs~c gE 1p ~2pr' lc- SM Aggregate Depth:
inches below pipe
inches above pipe
inches total
**If applicable: / understand the system type specified is different from the type specified on the dpp/ication. / accept the specifications of this permit.
Owner/Legal Representative Signature: Date:
- -.1- < -e p u, pdi, ur life Imellau use cnanges. the construction nutnoraahon shall not be transterred when there is a change in ownership of the site. This
Construction Authorization isn ect mpliance Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent: nZy\:S' Date: 3 vo to
Cons tion Authorization Expiration Date: f~
HTE# Permit # a5~tao
Harnett (bounty Department of h blic Health
Site ketch
PROPERTY LOCATON: Aa..KS VZ
ISSUED TO: 1-+'+c. c~ES ~csG SUBDIVISION ~s~~~d2fl LOT # -LA(~_
Authorized State Agent: 9ZA6 GLIVGa- 1 (N-11-SOOV ate: 3 L 1 D))Q
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