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HTE# /0 -S - Z,~B~ Harnett County Department of Public Health 2 5 7 3 8
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: 5/L/yd7 i
ISSUED T0: SUBDIVISION LOT #
NEW ( REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: ,t- S~t7lLKi•~ iN
Proposed Wastewater System Type: Z5~ 0, /
Projected Daily Flow: 3 (Q a GPD 134r46a~ . a 6; oA
Number of bedrooms: 3 Number of Occupants: max
Basement ❑Yes ❑ No
Pump Required: ❑Yes ❑ No ❑ M3fbe required based on final location and elevations of facilities
Type of Water Supply: ❑ Community W Public ❑ Well Distance from well feet Permit valid for. 2'ri-ve years
Permit conditions: ❑ No expiration
Authorized State Ag Date: - i SEE ATTACHED SITE SKETCH
The issuance of this permit a Health Department in 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 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 be installed in accordance
with the attached system layout. 2 I
ISSUED TO: PROPERTY LOCATION: -:K/907 G✓~41~,~~"p~~,D
SUBDIVISION LOT #
Facility Type: ~Lb lD1Z~4a~~ New ❑iExpansion ❑ Repair
Basement? ❑ Yes No Basement Fixtures? ❑ Yes No
Type of Wastewater System** is la X'6-hoz ~ s r~~ (Initial) Wastewater Flow: -5;~ 6 GPD
(See note below, if applicable z{y t4
O - i r)
Installation Requirements/Conditions Number of trenches 111
Septic Tank Size -/.00 y gallons
Pump Tank Size gallons
Pump Requirements: ft. TDH vs.
Conditions:
Exact length of each trench IS-4) feet
Trenches shall be installed on contour at a
Maximum Trench Depth of. 2(p /9 inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
GPM
Trench Spacing: 9 Feet on Center
Soil Cover: inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
Aggregate Depth:
_--(t2 inches below pipe
eZ inches above pipe
/Z inches total
**If applicable: /understand the system type rpecided is different from the type specified on the application. l accept the rpecilcationr of this permit
Owner/Legal Representative Signature: Date:
This Construction Authorization is subject to revocation if the site plan, plat, or the intended use chanties. The Construction Authorization shall not be transferred when there is a rhanoa in nw-hin of tha ata Thir
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 Age
Q9 Date:
Construction Authorization Expiration Date: Y - /4, d s-
HTE# Permit # 2 S 7~
Harnett County Department of 11~iblic Health
Site Sketch
PROPERTY LO(ATON;,~/Z l 0 4-7~)Icz 1~si ~Irn-pG-,E-~5
ISSUED T0: SUBDIVISION LOT #
Authorized State nt: Date:
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