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IPACHTE# j3 / '7 C Hati,ett County Department of Public rlealth Imarovement Permit 27500 A buildi g permit cannot be issued with only an Improvement Permit 7_; R� / ,, PROPERTY LOCATION: /8S'o ISSUED TO: r �ror (e ,se SUBDIVISION _v,i,, -1-4f 4 x LOT # 1.5' NEW 2' REPAIR ❑ EXP SION ❑ Site Improvements required prior to Construction Authorization Issuance: Type of Structure: E4; t-: '4 'SFn Proposed Wastewater System Type: c_ a _Q Projected Daily Flow: J 6 O GPD Number of bedrooms: 3 Number of Occupants: max Basement ❑Yes 9116 Pump Required: ❑Yes 9' o ❑ May be required based on final location and elevations of facilities Type of Water Supply: ❑ Community public ❑ Well Distance from well feet Permit valid for: CKFive years Permit conditions: ❑ No expiration Authorized State Agent:: v --- . /—cc ' IJ Date: I / i/ Z ° t l SEE ATTACHED SITE SKETCH The issuance of this permit by t 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 systemm/ layout. rr ISSUED T0: /� r- t �-�h ; �t<cU %�� i �fc PROPERTY LOCATION: / f�f G % : c Ra'• SUBDIVISION J Ife_ f R,dg,,_ LOT # /Jr_ Facility Type: 2"'New ❑ Expansion ❑ Repair Basement? ❑ Yes 2"'No Basement Fixtures? ❑ Yes ❑ No Type of Wastewater System ** C c.1 ✓e"-F: ----Q (Initial) Wastewater Flow: .3 ° GPD (See note below, if applicable ❑) n P­t C�.We,e �->o�JC (Repair) Installation Requirements /Conditions Number of trenches Septic Tank Size gallons Exact length of each trench % feet Trench Spacing: `� Feet on Center Pump Tank Size gallons Trenches shall be installed on contour at a Soil Cover: a2 inches Maximum Trench Depth of: 3 �- 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 Conditions: �u � 1, - ls� 1.'e M -.T1 9c cQ.pp'4 , �k' b °60X. on TeP c 4-a -w.k- S a .,SL he La,tcc ✓ed -,k- V _ ,.4;,r.,( -<- 6 inches below pipe Aggregate Depth: .2 inches above pipe /2, 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: I understand the system type specifled is different from the type speciTed on the application. / accept the specifIcatiom 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 Authorized State Agent Date: Construction Authorization Expiration Date: SEE ATTACHED SITE SKETCH HTE# H(arnett County Permit # dl"?S—bc� Depart lite] it of Public Health Site shetch Mha'MP4 PROPERTY LOCATON: /8,5-0 % All ISSUED TO: A- Tk" * lj ire SUBDIVISION LOT # IJ- Authorized State Agent: Date: I Li ,ea.