IPACHTE# 10 - -~~3y3 Harnett County Department of Public Health 2 6 0 4 3
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: Av (Z,pcr-, V_ -0
ISSUED TO: KES-4
SUBDIVISION _ L, rs c.. Q..,, LOT # 10-)
NEWX REPAIR ❑ ANSION El Site Improvements rewired prior to Construction Authorization Issuance:
Type of Structure: S FD C"" x fob q Proposed Wastewater System Type: K-'/&_,,,-5\0"'0.'1.,
Projected Daily Flow: 3~ d GPD
Number of bedrooms: 3 Number of Occupants: max
Basement ❑Yes No
Pump Required: ❑Yes ~No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community X Well Distance from well 14Z~C) Permit conditions: S,c,St W-4 (e feet
Permit valid for:
V54ive years
❑ No expiration
Authorized State Agent::
Date: 5 1 t SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the issuan ther permits. The permit holder is respo ible 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: kEr4JgGN C\Jrnrn sr~ G PROPERTY LOCATION: _ S~prtrzc~`i~
Facility Type: S FO SUBDIVISION f- LOT # to--)
New ❑ Expansion ❑ Repair
Basement? ❑ Yes No Basement Fixtures? ❑ Yes XNo
Type of Wastewater System- 00~t rEty o rv AL_
(See note below, if applicable (Initial) Wastewater Flow: 3C C> GPD
(::-c.t"'J "r< rat JX (Repair)
Installation Requirements/Conditions Number of trenches 9,
Septic Tank Size s-C)00 gallons Exact length of each trench
Pump Tank Size gallons _2 S feet Trench Spacing: Feet on Center
Trenches shall be installed on contour at a Soil Cover, t Y1 inches
Maximum Trench Depth of: O.~-30 inches (Maximum soil cover shall not exceed
(Trench bottoms shall be level to +1-114" 36" above the trench bottom)
in all directions)
Pump Requirements: ft. TON vs. GPM
inches below pipe
Conditions: o.: Eti L, ,v rR U t, g r lam' brio Aggregate Depth: inches above pipe
t~1 ~ EN~2o o,c.a1 Q rv 1 x.,.t, e-' Q_ P. c-. S ~s G S y3 r~ . ~ o uT st, '~S inches total
r,,L
If applicable: / uaderrtand the system type specified is different from the type specified on the applicatiofl. / accept the specifications of this permit
Owner/legal Representative Signature:
Date:
This Construction Authorization is sub' revocation d the site plan, plat, or the intended use (hanges. The Construction duthorization shall not be transferred when there is a change in ownership of the site. This
Construction Authorization is subject to compliance on the laws and Rules for Sewage Treatment and Dis oral and to the conditions of this ermit
P P SEE ATTACHED SITE SKETCH
Authorized State Agent:
Date: 5 ~3 1
o tion Authorization Expiration Date:
HTE# S C)' S- -_-'t3 t_j3 Permit # QL.~>OL4
Harnett County J*pa lment of Ftbfic Health
S'ite Sketch
PROPERTY LOCATON: Of~ ~~a Q
ISSUED T0: k Co mr,, v SUBDIVISION LN
-Tv~& LOT # -to
Authorized State Agent: R15)46 (C)L),V L Date: 51)3110
t 0.8D&Z-_