IPAC (2)-replaces original permit - due to lot conditions being changed after original IPAC writtenHTE# l3 "S=,7Joc-2- Harnua County Department of Public`` .realth
hDrovement Permit 27457
A building permit cannot be issued with only -annIImprovement Permit
PROPERTY LOCATION: , t ,�r Al.
ISSUED TO- / 'l c kee �I® �l SUBDIVISION Go,k/n%N-i LOT # a
NEW e REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: SF b (s r,7
Proposed Wastewater System Type: v. i. ki— u ed
Projected Daily Flow: (/8 0 GPD
Number of bedrooms: _ Number of Occupants: i max
Basement ❑Yes Z'No
Pump Required: Qfes ❑ No ❑ be required based on final location and elevations of facilities �
Type of Water Supply: El Community Ma Public El O Well Distance from well feet Permit valid for. Five years
Permit conditions: ❑ No expiration
Authorized State Agent:: / /�.._ ���, /� �.- �' „1CCID Date: .f"/7%2 SEE ATTACHED SITE SKETCH
The issuance of this permit by t e 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, .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: A C4, A A trr PROPERTY LOCATION:
SUBDIVISION dr k^-,'U - LOT # 9-1
Facility Type: �5-)Cb R” New ❑ Expansion ❑ Repairs�
Basement? I] Yes C -No Basement Fixtures? El Yes 1:1 No �� b 1Y I13
Type of Wastewater System ** v (Initial) Wastewater Flow: Y80 GPD
(See note below, if applicable ❑) j ; ` ` C K °'^J er- J Y-f fAe ``-
pZS�rd JQ (Repair) ff
Installation Requirements /Conditions Number of trenches ..�� / 6"
Septic Tank Size 100 O gallons Exact length of each trench --/" 3 00 feet Trench Spacing: 9 Feet on Center
Pump Tank Size /000 gallons Trenches shall be installed on contour at a o Soil Cover: (� `/6' inches
"'�
Maximum Trench Depth of:)O
fainches 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
t Aggregate Depth:
Conditions: J-o. , c)-r cC,, oqs c� ✓'G� ^ mac/ ,r -��;e t /? y t +-o b� Z_
,- ! c-e , 0, , (V 4v-ccr A eizi4
WATER LINES (INCLUDING IRRIGATION) MIDST BE ]OFT. FROM ANY PART OF SEPTIC SYSTEM OR REPAIR AREA.
NO UTILITIES ALLOWED IN INITIAL OR REPAIR DRAIN FIELD AREA.
inches below pipe
inches above pipe
inches total
* *If applicable: / understand the system type specified is different from the type specified on the app /icatiom / accept the specifications of this permit
Owner /Legal Representative Signature: Date:
This Construction Authorization is subject to 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 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
C
Authorized State Agent- Q0., Date: J 2 CIO _
Construction Authorization Expiration Date: -r-17IZV16
HTE# 13 —J-- J J 0 '-- �
Permit # Z? Yr7
H(arnett County Dep artment of ic Health
Site Sketch
PROPERTY LOCATON:
ISSUED TO: A c SUBDIVISION LOT # -2, 1
Authorized State Agent:
w # Date:
CC /A C— co C -k-
ap I
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