IPACHTE# ia- s- 12- -3 Fil Harnett County Department of Public Health 2 5 S 4 6
Improvement Permit
A building permit cannot be issued with only an Im rove~}ent Permit
/ PROPERTY LOCATIO : cr KJ ~~j
ISSUED TO: SUBDIVISION _ Lk:tt rr LOT # 1,
NEW REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure:
Proposed Wastewater System T~ype: VeA C ~a1
Projected Daily Flow: 3 03 GPD
Number of bedrooms: -7 Number of Occupants: (L max
Basement ❑Yes C No
Pump Required: ❑Yes ItTlo ❑ Ma be required based on final location and elevations of facilities ~
Type of Water Supply: ❑ Community Public ❑ Well Distance from well feet Permit valid for. 2 Five years
Permit conditions: ❑ No expiration
Authorized State Agent:: Date: SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in now arantees 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 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, .19SS, .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 TO: 4'. ti PROPERTY LOCATIO : Air "Q-
SUBDIVISION J c--;t,4 LOT #
Facility Type: C~New ❑ Expansion ❑ Repair
Basement? ❑ Yes Cpl' No Basement Fixtures? ❑ Ye ❑ No
Type of Wastewater System** ~C ~t. (Initial) Wastewater Flow: GPD
(See note below, if applicable
C0"L Lit- ( c;'4"- (Repair)
Installation Requirements/Conditions Number of trenches
Septic Tank Size 00C) gallons Exact length of each trench rO feet
Pump Tank Size gallons Trenches shall be installed on coV!--70 ur at a
Maximum Trench Depth of. c2 inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
Pump Requirements: ft. TDH vs. GPM
Conditions:y / ) C ~'3 k' ( : ~ "J-
Trench Spacing: Feet on Center
Soil Cover: C~ l8 inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
C inches below pipe
Aggregate Depth: P2- inches above pipe
l inches total
**If applicable: / understand the system type specified is different from the type specified on the application. l accept the specifications of thin permit
Owner/legal Representative Signature: Date:
iiU WnWULL1011 Aumonzauon is suufea m revocation it the site plan, plat, or me 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: Date:
Construction Authorization Expiration Date:
Q
HTE# Permit # a2 5-FVL
narnett County -I)epailment of -n-twic nealth
k v i to Sketch
PROPERTY LOCATON: 14"'.- ~ 0.
ISSUED T0: SUBDIVISION LOT #
Authorized State Agent: 4,',
C Date: _ A, lac I
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