IPACHTE# 13- 5- 3)5 -` /0 Harnett County Department of Public Health
Imurovement Permit 27485
A building permit cannot be issued with only an Improv Sent Permit
PROPERTY LOCATION: c2 y t 2 �J'
ISSUED TO: or ✓-C � 1 - ( SUBDIVISION LOT #
NEW LAY REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: SFO
Proposed Wastewater System Type:
Projected Daily Flow: GPD
Number of bedrooms: Number of Occupants: V max
Basement ❑Yes RI'lo
Pump Required: ❑Yes 26o F-1 May be required based on final location and elevations of facilities
Type of Water Supply: El Community 2 Public ❑ Well Distance from well feet Permit valid for: Ea- —Five years
Permit conditions: ❑ No expiration
Authorized State Agent:: Date: 6 SEE ATTACHED SITE SKETCH
The issuance of this permit by fe 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 T0: �.G r✓� : �� M ��e / PROPERTY LOCATION: a Y/.t dv/4 -r ' ?w,P/
SUBDIVISION LOT #
Facility Type: , fr y EJ New ❑ Expansion ❑ Repair
Basement? ❑ Yes ❑ No Basement Fixtures? ❑ Yes ❑ No
Type of Wastewater System ** (Initial) Wastewater Flow: 960 GPD
(See note below, if applicable ❑)
C,o.1, ✓en.� = ��� (Repair)
Installation Requirements /Conditions Number of trenches
Septic Tank Size gallons
Pump Tank Size gallons
Pump Requirements: ft. TDH vs.
Conditions: PvC Colt= -7C—e.%
Cpl( 6e v✓'e .���J -'>t'
Exact length of each trench OSJa feet Trench Spacing: 9 Feet on Center
Trenches shall be installed on contour at a Soil Cover: 18• aY inches
Maximum Trench Depth of. -k -3�-- inches (Maximum soil cover shall not exceed
(Trench bottoms shall be level to +/ -1/4" 36" above the trench bottom)
in all directions)
GPM inches below pipe
Aggregate Depth: inches above pipe
inches total
e-.
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 speciped is different from the type speciped on the app lication. / 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
Authorized State Agent: Date: r -9-6 (rz' /3
Construction Authorization Expiration Date: 4 128 1.2,;� 16
HTE# /, — 5= 31S'Yv Permit # 027S{6j
arnett County Department of Public e (alth
Site Sketch
PROPERTY LOCATON: 02 �t Z 1l y✓`J-r
ISSUED TO: CAJe SUBDIVISION C�.,��Y•� LOT # �_
Authorized State Agent: /" way, eti% Date: 6
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