IPAC RHTE#ocl 2 Harnett County Department of Public Health 9 3 9
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: Gau 1CN\
ISSUED T0: SUBDIVISION
LOT #
NEWA
REPAIR
'ti
_ EXP'M El
X'
'
Type of Structure:
C
op
-la
T I
Proposed Wastewater
System Type:
Ca 6 so ri- P, L
Projected Daily Flow:
3(- 0
GPD
Number of bedrooms:
3
'
Number of Occupants: max
Basement ❑Yes
XNo
Site Improvements required prior to Construction Authorization Issuance:
Pump Required: ❑Yes X No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community Public ❑ Well Distance from well X00 feet Permit valid for: Five years
Permit conditions: - ❑ No expiration
Authorized State Agent:: QL--S Date: 3 `-6 l0 SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the issuance o er permits. The permit hol er 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 it 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, .1955, .1956, .1957, .1958. and .1959 are incorporated by references into this permit and shall be met. Systems shall b
with the attached system layout.
ISSUED TO: CN-'00 0'+ o \ao,-; 5 PROPERTY LOCATION:
SUBDIVISION
Facility Type: M0 S) ~'',-7 4 / N New ❑ Expansion ❑ Repair
Basement? ❑ Yes No Basement Fixtures? ❑ Yes N/No
Type of Wastewater System** G, rt -r S -t-, ~ U t-4SX L, (Initial) Wastewater Flow:
(See note below, if applicable
A6 °/s CEO vc-K .v 'J (Repair)
Installation Requirements/Conditions Number of trenches ti
Septic Tank Size t o in o gallons Exact length of each trench *l feet
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of: )i " a inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
Pump Requirements: ft. TDH vs. GPM
Conditions: g-y~n, M 5 g E 10 X24 r, 5 P L
V ` T ` GS A 1 LCI O t~ C~ ~v cwt ~'s sty v atL
installed in accordance
LOT #
3~b GPD
Trench Spacing: Feet on Center
Soil Cover: inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
~O inches below pipe
Aggregate Depth: inches above pipe
b 1 a inches total
**If applicable: / understand the system type rpecided is diNerent from the type rpecided on the application. l accept the rpeci6cationr of this permit
Owner/Legal Representative Signature: Date:
This Construction Authorization is subject to re atom if the s Ian, plat, or the intended use changes. The Construction Authorization shall not be transferred when there is a change in ownership of the site. This
Construction Authorization is stjecto complianc n he Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit. SEE ATTACHED SITE SKETCH
Authorized State Agent: ~H Date: 3 a< G
Con ction Authorization Expiration Date: a~
HTE# Permit # 2L553~
Harnett (lonntti Department of 1'liblic Health.
v i to Sketch
PROPERTY LOCATON: Ms. O L• jC
ISSUED TO: C;-,3 -C,,o o- ~ SUBDIVISION LOT #
Authorized State Agent:
O CLA ~~S
v-, s
Date: 31 _51)0
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