IPAC RHTE# 13 ^3�C3i� arnett County Department of Public Health
Improvement Permit 27517
A building permit cannot be issued with only an�mprovement ermit
PROPERTY LOCATION: C
ISSUED TO: -ioN t rt'5 ya—'10 N SUBDIVISION 1' 1 s Ze, LOT #
NEW>< REPAIR ❑ EXP SION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: 'r;:) Q- D (flex d'
Proposed Wastewater System Type: 9 5% QeZw \0,4 yzi'a rr,
Projected Daily Flow: GPD
Number of bedrooms: Number of Occupants: 10 max
Basement []Yes KNo
Pump Required: ❑Yes No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community �K Public ❑ Well Distance from well l ®d feet Permit valid for: Five years
Permit conditiotrs — ❑ No expiration
s
Authorized State Agent:: �' Date: c- "1 13 SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department i no way guarantees the issuao ther permits. The permit hold r 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 T0:
Facility Type: r� XNew
Basement? ❑ Yes '� No Basement Fixtures? ❑ Yes
Type of Wastewater System" °% ow
(See note below, if applicable
PROPERTY LOCATION: oe.-. Qb
SUBDIVISION ^1 X10-; E LOT # 1
❑ Expansion ❑ Repair
No
y" (Initial) Wastewater Flow: C) GPD
❑) 0 �/" (Repair)
Installation Requirements /Conditions Number of trenches 3
Septic Tank Size gallons Exact length of each trench °1® feet Trench Spacing: °) Feet on Center
Pump Tank Size gallons Trenches shall be installed on contour at a Soil Cover: ate °lam inches
Maximum Trench Depth of: 34� a4 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
Aggregate Depth:
Conditions:
WATER LINES (INCLUDING IRRIGATION) MUST 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: l understand the system type specified is different from the type specifed on the application. l accept the specifications of this permit.
Owner /Legal Representative_ Si nature: Date:
This Construction Authorization is subject to revo—mkif the site plariplat, 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 subjempliance witpr ' of s and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent:
FL:5 Date: -1701
Expiration Date:
Permit # Z�:l 51
Harnett County Department of Public He(-I,Itli
Site sketch
M