IPACHTE# Harnett County Department of Public Health 2 5 9 4 6
Improvement Permit
A building permit cannot be issued with only an improvement Permit
PROPERTY LOCATION:_
ISSUED T0: u r} (ca fz u cis p( ~0 ~ SUBDIVISION -oa LOT # __1__
NEWA REPAIR ❑ PANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: _ S r'$:_) (31'x y g
Proposed Wastewater System Type: V~sjM? Gs 0,4
Projected Daily flow: _ GPD
Number of bedrooms: Number of Occupants: max
Basement []Yes No
Pump Required."es ❑ No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community X Public ❑ Well Distance from well I O 0 feet
Permit valid for ~ Five years
Permit conditions:-
❑ No expiration
Authorized State Agent::
The issuance of this permit by the Health Department in no way guarantees the ct
site is subject to revocation if the site plan, plat, or the intended use changes. The Im
the Laws and Rules for Sewage Treatment and Disposal and to conditions of this permit..
Date: S~36~1c; SEE ATTACHED SITE SKETCH
of other permits. The permit holder is responsible for checking with appropriate governing bodies in meeting their requirements. This
cement Permit shall not be affected by a change in ownership of the site. This permit is subject to compliance with the provisions of
Construction Authorization
(Required for Building Permit
The construction and installation requirements of Rules .1950, .1952, .1954, .1955, .1956, .1957, .1958. and .1959 are incorporated by references into this permit and shall be met. Systems shall be installed in accordance
with the attached system layout
ISSUED TO: 'A ~'A Co c-; (x L.5 ~ A PROPERTY LOCATION: LErwyEL b i-r , c,.,_ ~ r
SUBDIVISION Yo(uc.- V A2) h~]
Facility Type: 5V- C 3 y$~ New El Expansion ❑ Repair LOT #
Basement? ❑ Yes No Basement Fixtures? ❑ Yes XNo
Type of Wastewater System** (UUr-, \e Sy5-7e" (Initial) Wastewater Flow: GPD
(See note below, if applicable
~'2-'~ ~2r~aGcma sv~CJa ~R.ET2~~ (Repair)
Installation Requirements/Conditions Number of trenches I
Septic Tank Size _ l Q q.3 G gallons Exact length of each trench EIC) feet Trench Spacing:
Pump Tank Size ypae ~ Feet on Center
gallons Trenches shall be installed on contour at a Soil Cover inches
Maximum Trench Depth of. 1'?, inches (Maximum soil cover shall not exceed
(Trench bottoms shall be level to +/-1/4" 36" above the trench bottom)
in all directions)
Pump Requirements: ft. TDH vs. GPM
inches below pipe
_ Aggregate Depth: inches above Conditions: "EEt:3b-) S~. Et Gc-) oc ~ F-Z rNL> pipe
inches total
M,,y; gE tO' ~20~ ~Frr-c.L `3ys: E!'^ -"T"vS ftuw-; 8;5E0 ON A4~SAL eq PPLSu>,oS1S SotL G~ZO
If applicable: / understand the system type speciCed is different from the type specifled on the app/icuion. / accept the specifications of thin permit.
Owner/legal Representative Signature: Date:
This Construction Authorization is subject ovation if the site plan, 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 su ~ect to compiia w rove' of the laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent: QJC Date: 330
ruction Authorization Expiration Date: ~ ~o S
HTE# Permit # C
Harnett County Depallluelit of ,tbhc Health
ite 'Shetc tl
ISSUED T0: co _ PROPERTY LOCATON: uE~ gLp,c.,- Qb
~H SUBDIVISION C=oc: ~s 5 dA~C S 3 LOT # h1
Authorized State Agent: ~i5u7t_~~Esz'T0Ll~s0c2~1 Date: 3136' G
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