IPAC RType of Structure: ! ldv
Proposed Wastewater System Type: a5 °lei 000"i01-3 SyS-TG"n
Projected Daily Flow: _ -2- GPD
Number of bedrooms: Number of Occupants: max
Basement ❑Yes ANo
Pump Required: ❑Yes �<No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: El Community "'54 Public ❑ Well Distance from well 100 feet
Permit conditions:
Permit valid for:
,,Five years
❑ No expiration
Authorized State Agent:: ��� ���w.���t Date: .a.] )`81)a SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the issuan2- 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 Improvem t II 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 onditio of this per
Construction Authorize ' n
(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. �OrrpCi� sPaN%y ®�
ISSUED TO: rsaz- PROPERTY LOCATION: \v4p',-Y- Z
SUBDIVISION e✓ e0-s 5 10 G LOT #
Facility Type: MOD New ❑ Expansion ❑ Repair
Basement? ❑ Yes X No Basement Fixtures? ❑ Yes No
Type of Wastewater System ** 2.S% REDue'-"'o "i Sys-5 (Initial) Wastewater Flow: -3GQ GPD
(See note below, if applicable ❑)
UL'SrtwSs- PLL4' D.S% Sys sE en (Repair)
Installation Requirements /Conditions Number of trenches 3
Septic Tank Size t 6b c) gallons Exact length of each trench 1 O(Z) 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. \4 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
Conditions:
a
Aggregate Depth: inches above pipe
'0'� b inches total
* *If applicable: l under tend the system type speciped it different from the type speciFed on the application. / accept the specipcations of this permit.
Owner /Legal Representative Signature: Date:
This Construction Authorization is subject to �rlancetioniftthe lan, 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 subject to com f the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit. SEE ATTACHED SITE SKETCH
Authorized State Agent: Date: a4 is \D
Ntisc� 5�1� Const tion Authorization Expiration Date: �lC
HTE# 0�-- 5 =a�L)A R- -i 13 -J Nc�9 Permit # &S
Harnett County ty e partment of 1�ihlic Health
Site Sketch
ISSUED TO:
Authorized S
ZP
0"SN ) 14 Q-1 10 'W c �
DDAD[DTV I Af ATAII. \_N w, - (-n \Y n
LOT # Q,