IPACHTE# IC-, 6 76 Harnett County Department of Public Health 2 5 9 5 7
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION c, r j ed,
ISSUED T ylcl C',- ' SUBDIVISION ~n LOT #
NEW REPAIR ❑ t EXPANSION ❑ Site Improvements required prior to construction Authorization Issuance:
Type of Structure: F S~ X~
Proposed Wastewater System Type: Co1Vz-k I 1~K
Projected Daily Flow: J w GPD
Number of bedrooms: -~13 Number of Occupants: L max
Basement ❑Yes lt1 No
Pump Required: ❑Yes ❑ No f/ Mae required based on final location and elevations of facilities
Type of Water Supply: ❑ community L Public ❑ Well Distance from well feet Permit valid for ZFive years
Permit conditions: ❑ No expiration
Authorized State Agent:: crc~ / Date: 02't /2 c/o SEE ATTACHED SITE SKETEH
The issuance of this permit by the Health Departm " no way 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 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 .19SO, .1952, .1954, .1955, .1956, _1951, .1956. 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: inn l c C Tic PROPERTY LOCATIO : ar ~I
SUBDIVISION C IL' d'd LOT # Rio
Facility Type: ~r Z"New ❑ Expansion ❑ Repair
Basement? ❑ Yes No Basement Fixtures? ❑ s ❑ No
Type of Wastewater System** cc A_f _<A ~ (Initial) Wastewater Flow: ( GPD
(See note below, if applicable
C s`iJc`1~ ' a't (Repair)
Installation Requirements/Conditions Number of trenches Z
Septic Tank Size _./030 gallons Exact length of each trench 2J r feet
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of. /S '--"0 inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
Pump Requirements: ft. TDH vs. GPM
Trench Spacing: 9 Feet on Center
Soil Cover: inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
Aggregate Depth:
Conditions:
~C~1 Ch rs r~Air ca~cc r. Ll vJ~~ cam- C ~e-r /t 'f t-G
inches below pipe
inches above pipe
l~ inches total
ati 'z.n
t**lf applicable: / understand the system type ,rpecired it different from the type specified on the application. / accept the .rpecidcationr of this permit,
Owner/Legal Representative Signature: Date:
This Construction Authorization is subiect to revnratinn if tha uta nlan nint nr rho immndod n<o rh-- Th.
-111 „ w b,. - -""'T v' um rim.
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 Agen . Dater' oZ ~ff / a
Construction Authorization Expiration Date.
a Y a
HTE# Permit # c2 S- i j- 7
Harnett County Depar(meut of Public Health
bite ~ vetch
PROPERTY LOCATON: ~.r .
ISSUED T0:,i,~✓~ SUBDIVISION rd LOT # l/6
Authorized State Agent: Date: < 7/d
10
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D Emvi Health aad Natural Resou~cp sheet:
Owsite w SXdn Property a.
Lot ii:
SOIUSPI'>t &VALUATION File k
fOr OM M WASTLWATZR MTiM Cade:
Owner. Applicant; /
Address: Dpi EvWW d:
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