IPAC RHTE#
Harnett County Department of Public Health
2 5 9 2 $
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: L,ExnsaLz. ~L-AG\<.. V,0
V,0
ISSUED TO: ~~`~(2vc. %OQ-5 C SUBDIVISION 1 oC c t~A~S Q,`2,
LOT #
NEWA
REPAIR ❑ EX SION ❑ Site Improvements required prior to Construction Autho
rization Issuance:
Type of Structure:
Proposed Wastewater System Type:
Projected Daily flow:
X60
GPD C_o r'4 -J e--v 0 N L
Number of bedrooms:
3
Number of Occupants: !o max
Basement ❑Yes
XNo
Pump Required: ❑Yes
'X No
❑ May be required based on final location and elevations of facilities
Type of Water Supply:
❑ Community
1)< Public ❑ Well Distance from well TOO feet Permit valid for:
Five years
Permit conditions:
❑ No expiration
Authorized State Agent:: REDS Date: 3~~0 SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the is a of other permits. The permit hol er is sponsible 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 Impr tent 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, .1955, .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: 1A *~A Co, ,:5,a,,c--coa5
~,A L PROPERTY LOCATION:
LEMvEz--
SUBDIVISION moo->u~e
C~A~S ~3 LOT # 132.
e: S C3$ x~ /
Facilit
T
N
y
yp
ew ❑ Expansion ❑
Repair
Basement? ❑ Yes X No Basement Fixtures? ❑ Yes A No
Type of Wastewater System** - Q410 T
o Nv Es,: w rv
o, t~nitial) Wastewater Flow: GPD
(See note below, if applicable
C;o E"' -,z 1 o K r~" t, ,IV
pi" 00Q,
(Repair)
Installation Requirements/Conditions
Number of trenches 3
Septic Tank Size IcS od gallons
Exact length of each trench 100
feet
Trench Spacing: Feet on Center
Pump Tank Size gallons
Trenches shall be installed on contour at a
Soil (over: N a inches
Maximum Trench Depth of:
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 j e
Conditions: W-,-r5--a, Lx
C) r-, 1N
pp
Aggregate Depth: inches above pipe
5 y5 , 6°^ , 1~ 0 1-:4- inches total
**If applicable: /understand the system type rpeci6ed is different from the type speciCed on the application. / accept the specllmwonr of this permit.
Owner/Legal Representative Signature: Date:
This Construction Authorization is so$jec-t revocation 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 sobject~o complianwitt~ v s 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: 3 1 $ a
Con tion Authorization Expiration Date: \s N6--
C> V:.- ua, r3 6-, PCLv-1~w~` t_..c5 ~>,.t~ 0" 4 Jy~ yn cs ~
fHTE# Permit # a5~
ISSUED T0: "
Authorized State Agent:
Harnett County Depailment of 11i blic Health
Site Sketch
PROPERTY LOCATON: L-15-,012j-
SUBDIVISION F~oaE.r Oar QN3 LOT #
L--.t Eaf, o r ~SPoCtF Date:
• 9- 1ZCO IFOL •JEw P2~VEwtay
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8 AsX.C~
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