IPACHTE# ~0-~- Harnett County Department of Public Health 2 6 0 2 3
PROPERTY LOCATION. ~Qv,S V-n
ISSUED TO: W ~cvcc CU c ~y cc y G i SUBDIVISION - N-N W d 2s7 LOT # 11~
NEWX REPAIR ❑ EtANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: S O (5(y
Proposed Wastewater System Type: Pv Mc'--S 0 Co
Projected Daily Flow: D GPD
Number of bedrooms: 3 Number of Occupants: G max
Basement ❑Yes -2~,No
Pump Required `s ,Yes ❑ No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community Public ❑ Well Distance from well 1 ~d feet Permit valid for Five years
Permit conditions: ❑ No expiration
Authorized State Agent:: Date: 16 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 respon ble 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, .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: V, yN"t a,uc--S~e,I PROPERTY LOCATION: M~2~5
SUBDIVISION P~Woci.9 LOT # 41~
Facility Type: S~S7L~~ Q) New ❑ Expansion ❑ Repair
Basement? ❑ Yes No Basement Fixtures? ❑ Yes '~)(No
Type of Wastewater System" Pu Co N-1ci'm U T1~ p,L (Initial) Wastewater Flow: o0 GPD
(See note below, if applicable
Pu ~Q 1 a Ca N -1 C-N'~ N P.L._ (Repair)
Installation Requirements/Conditions Number of trenches 1
Septic Tank Size LC) S5 Q gallons Exact length of each trench S so feet Trench Spacing: Feet on Center
Pump Tank Size gallons Trenches shall be installed on contour at a Soil Cover: & inches
Maximum Trench Depth of: Sc6 -~U 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
A regate Depth: inches above pipe
Conditions: ~ v.X Qs:z-- L, ~~5N ~E eg-> LC -S y !5-, E r inches total
MPS C Std AG`~'~ .a s-tlAu Gc2 - P.,cZ GP. iTa,~ ~ 3J ON P~ Q~oPas>~2 .
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If applicable: /understand the system type specified is different from the type specified on the app/ication. / accept the specifications of this permit.
Owner/Legal Representative Signature: Date:
nuin 1-lum-luuu- ~u i`c. -uu n me ptac, or me mrenueo use cnanges. the construcuon aurnonzanon shalt not be transferred when there is a change in ownership of the site. This
Construction Authorization is suY( st to compliance h t tis ` e Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit. SEE ATTACHED SITE SKETCH
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
Authorized State Agent: ~~~i cz GMS Date: ~.b
Constr~n Authorization Expiration Date: `-S ~G v
HTE# t 4" 5- a3~~ 1 Permit #
Harnett County Department of ll~ blic Health
Site Sketch
ISSUED TO:
Authorized State Agent:
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