IPAC RHTE# � Harisett County Department of Public jealth
hDrovement Permit 27430
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: ®ae�
ISSUED TO: L--. _C_ SUBDIVISION Q2v �.,oGrZ LOT #
NEWK REPAIR ❑ EXPA N ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure:
Proposed Wastewater syq T e: Pump \S cs Q-G'If C Vcr, 104}
Projected Daily Flow: t-1' GPD
Number of bedrooms: Number of Occupants"( max
Basement []Yes No
Pump Required:N'Yes ❑ No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community X Public ❑ Well Distance from well 100 feet Permit valid for Five years
Permit conditions: _ ❑ No expiration
Authorized State Agent:: ` \ � \� Sc' C-� � Date: `'► ):Z5 thi SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in uarantees tie iss sf other permits. The permit holder n ible 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 mprovei it 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 t ons o 's per
3
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: Q;QC�' L_LC, PROPERTY LOCATION: 0 0("B
SUBDIVISION ! iU26 LOT # �
Facility Type: �'`�� New ❑ Expansion ❑ Repair
Basement? ❑ Yes __-4RL No Basement Fixtures? El Yes _X No
is
Type of Wastewater System ** P v rne 1 o C-- k n>J (Initial) Wastewater Flow: 3L 0 GPD
(See note below, if applicable ❑)
VQ cYe9_7_® Q4-Elc r.. vim, lc;3a (Repair)
Installation Requirements /Conditions Number of trenches X -4•
Septic Tank Size ! Q® Z gallons Exact length of each trench t feet
Pump Tank Size l C>00 gallons Trenches shall be installed on contour at a
Maximum Trench Depth of i"� inches
(Trench bottoms shall be level to +/ -1/4"
in all directions)
Pump Requirements: ft. TDH vs. GPM
Conditions:
Trench Spacing: Feet on Center
Soil Cover: C' I inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
inches below pipe
Aggregate Depth: inches above pipe
inches total
WATER LINES (INCLUDING IRRIGATION) MUST BE LOFT. FROM ANY PART OF SEPTIC SYSTEM OR REPAIR AREA.
NO UTILITIES ALLOWED IN INITIAL OR REPAIR DRAIN FIELD AREA.
* *If applicable: / understand the system type specified yi different from the type specified on the app lication. / accept the specifications of this permit.
Owner /Legal Representative Signature: Date:
This Construction Authorizat�ub�ct 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 446ject to cqk witlyj visions 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: Ji j ruction Authorization Expiration Date:
HTE # � --,? - 5— T'S' 2 Permit # �O L� 3 0
Authorized State Agent: -TO OC--Z)O�)-Date: