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Harnett County Department of Public Health
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Improvement Permit
A building permit cannot be issued with only an I rovemgnt Permit
PROPERTY L
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ISSUED TO:
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SUBDIVISION
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LOT # -
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NEW F~r
REPAIR ❑
EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: J
7F J) 4/8 x
Proposed Wastewater System Type: C
OnUen. ~A tk
Projected Daily flow
3(g,
GPD
Number of bedrooms:
Number of Occupants: max
Basement ❑Yes
Co
Pump Required: ❑Yes
❑ No
E3May bb required based on final location and elevations of facilities
Type of Water Supply:
El Community
1T Public ❑ Well Distance from well feet Permit valid for
P-rive e years
Permit conditions:
❑ No expiration
Authorized State Agent:: ' Date: ~~2F124r o SEE ATTACHED SITE SKETCH
The issuance of this permit by Health De artment 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: ,,,,Ya•ti ( /'1
~„4r1rUc1,'e6- PROPERTY LOCAT :
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SUBDIVISION Des- cv .mil LOT # ,Q C/
Facility Type: ~d New ❑ Expansion ❑ Repair
Basement? ❑ Yes No Basement Fixt res? ❑ Yes ❑ No
Type of Wastewater System** C v c-, o~ (Initial) Wastewater Flow: 3Gc~ GPD
(See note below, if applicable
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Installation Re uirements/Conditions
Septic Tank Size _ OOa gallons
Pump Tank Size gallons
Pump Requirements: ft. TDH vs.
pair)
Number of trenches
Exact length of each trench feet
Trenches shall be installed on c tour at a
Maximum Trench Depth of inches
(Trench bottoms shall be level to +/-I/
in all directions) /8 - ~
GPM 5-11 ;7 ~2--i0
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of
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Trench Spacing: Feet on Center
Soil Cover inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
inches below pipe
Aggregate Depth: a2 inches above pipe
inches total
**If applicable: / understand the system type soeci6ed is different from the type specified on the applicdtion. / accept the specifications o/ this permit.
Owner/Legal Representative Signature: Date:
>oufcu w -til.4uun it me >rte plan, plat, or me mtenaea use cnanges. me Construction Authorization shall not be transferred when there is a change in ownership of the site. This
Construction Authorization is subject to compI a 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 Agen Date: /,,ol
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Construction Authorization Expiration Date: z c%S-
HTE# Permit # -Z 07c,'
Harnett ('ounty Department of Public Health
Site sketch
PROPERTY LOCATON: A" ,-rkr
ISSUED T0: SUBDIVISION G,t ar 3.~ wr LOT # ►2~
Authorized State Agent
pct Date: `112,P-12-`K0
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