IPAC RHTE# !o zyb g~ Harnett County Department of Public Health 2 5 7 4 9
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LO(ATION-/s-Z-l
ISSUED TO;-//+ T~ L~s-4 ~J,y SUBDIVISION _ ~Ja/,tcvf Lic~t/~y LOT #
NEW REPAIR ❑ EXPANS N ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: Awr)-_"
Proposed Wastewater System Type: - .N c
Projected Daily Flow: 3400 GPD
Number of bedrooms: 3 Number of Occupants: max
Basement ❑Yes C~No
Pump Required: ❑Yes ❑ No 2 May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community [Z Public ❑ Well Distance from well feet Permit valid for. Five years
Permit conditions: ❑ No expiration
Authorized State Agent ,1 Date: s /Z - i o SEE ATTACHED SITE SKETCH
The issuance of this permit by 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, .1957, .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: PROPERTY LOCATION: l/
SUBDIVISION tit 1411 ~G 211-- LOT #
Facility Type: /-t ~ New ❑ Expansion ❑ Repair
Basement? ❑ Yes L7 No Basement Fixtures? ❑ Yes C No
Type of Wastewater System" (Initial) Wastewater Flow: 3,1,,0 GPD
(See note below, if applicable
'M -1 LOS M (Repair)
Installation Requirements/Conditions Number of trenches 3
Septic Tank Size /600 gallons
Pump Tank Size Zot* gallons
3 - %2, c) V'0 vc s
Pump Requirements: ft. TDH vs.
I/
Exact length of each trench 14> 0 feet
Trenches shall be installed on contour at a
Maximum Trench Depth of: /Z"
-,,,inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
GPM
Trench Spacing: y Feet on Center
Soil Cover: inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
inches below pipe
v1 Aggregate Depth: L_ inches above pipe
(onditions: C.o,)0e, -C~ c inches total
/ -57
i
**If applicable: / anderstand the system type specified /s different from the type specified on the app/icatioo. / accept the specifcationr 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 Consrrurtinn dorhmmntinn thnil not ho tnn f--4 ,mho„ A... , .ti,., e , ...u: _r .G. n:.
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 oermit. SEE ATTACHFn SITE SKFT(H
Authorized State Agolf-_ Date: f -
f Construction Authorization Expiration Date: t;-_ - r L - t .5
NTE# /b - s- - z'Y d g L 2 Permit #
Harnett County Department of 1"liblic Health
Site Sketch
PROPERTY LOCATON;~C-/S~/ 74 ISSUED T0: -✓.e~,-~~ Lrsaa ~/e.~,vr~~... SUBDIVISION LOT #
Authorized State Age 6~_~~•-~ - Date: - z 2
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