IPACHTE# LO 5 ~3~0
Harnett County Department of Public Health 2 5 9 4 9
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: BE-S~1Et $Pft"C,S~ Qp
ISSUED TO: S N i;, ,,r C4~) Htr~, , Co SUBDIVISION LOT #
NEW ❑ REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: 21 t P' flO , os1 ~~~^r~`EfzC+~~
Proposed Wastewater System Type: G-x-s- )ti
Projected Daily Flow: GPD
Number of bedrooms: Number of Occupants: max
Basement ❑Yes No
Pump Required: ❑Yes e:E!!~No ❑ May be required based on final location and elevations of facilities
Type of Water Supple Community X~ Public ❑ Well Distance from well LC? feet Permit valid for. Five years
Permit conditions: c. ep t- ~ QQ L-m -%o N ❑ No expiration
Authorized State Agenr.: Date: 3\3~N NN I) SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the issua f other permits. The permit holder is res nsible for checking with appropriate governing bodies in meeting their requirements. This
site is subject to revocation if the site plan, plat, or the intended use changes. The Improvement Permit shall not be affected by a change in ownership of the site. This permit is subject to compliance with the provisions of
the laws and Rules for Sewage Treatment and Disposal and to conditions of this permit.
Construction Authorization
(Required for Building Permit)
The construction and installation requirements of Rules .1950, .1952, .1954, ASS, .1956, .1952, .1958. and .1959 are incorporated by references into this permit and shall be met Systems shall be installed in accordance
with the attached system layout
ISSUED TO: S,.~a~.v ~s+$^~. Q , , lv L PROPERTY LOCATION: "aO
SUBDIVISION LOT # 5
Facility Type: r, "Q ❑ New\~❑ Expansion ❑ Repair
Basement? ❑ Yes No Basement Fixtures? ❑ Yes X No
Type of Wastewater System** 5- x S j s N f
(See note below, if applicable CIO N-4 G N AFL.- (Repair)
Installation Requirements/Conditions Number of trenches ZA P'5 z N C.
Septic Tank Size gallons Exact length of each trench 5 t sfm feet
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of: inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
Pump Requirements: ft. TDH vs. GPM
Conditions: -E
(Initial) Wastewater Flow: GPD
Trench Spacing: Feet on Center
Soil Cover: inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
Aggregate Depth:
inches below pipe
inches above pipe
inches total
**If applicable: /understand the system type rpeciled it different from the type rpeciped on the application. /accept the rpeci6cationr of thu permit
Owner/Legal Representative Signature: Date:
inis consuruction nutnonzaton is su o revocation it t site plan, plat, or the intended use changes. The tonstruction Authorization shall not be transferred when there is a change in ownership of the site. This
Construction Authorization ito compliangwi f the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit. SEE ATTACHED SITE SKETCH
Authorized State Agent: was Date:
3 161 1 ib
uction Authorization Expiration Date: 3 3
HTE# Permit #
Harnett Connt`, Depa linent of ll riblic Health
Site ketch
PROPERTY LO(ATON:
ISSUED TO: Sr10~`~ ~o . C-0 . 1NG SUBDIVISION LOT
Authorized State Agent:
Date: 3 34 to
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