IPACHTE#I C) - 5-----L1i'i= Harnett County Department of Public Health 2 6 0 4 5
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
ISSUED T0: PROPERTY LOCATION: -P1V-rv~_,
rI ~iw_ P>29 ~v~ w SUBDIVISION
A'Sv+FOQ~1
NEW REPAIR AIR ❑ ANSION ❑ LOT #
Site Improvements required prior to Construction Authorization Issuance:
Type of
Structure: SF 0
Proposed Wastewater System Tyype: _ r~5> a o~~ y ~~~M
Projected Daily Flow: `6b GPD
Number of bedrooms: Number of Occupants: 100 max
Basement ❑Yes No
Pump Required: ❑Yes ❑ No Allay be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community Public ❑ Well Distance from well tb0 feet
Permit conditions: Permit valid for X Five years
❑ No expiration
Authorized State Agent:: -
The issuance of this permit by the Health Department in no way guarantees the iss t
site is subject to revocation if the site plan, plat, or the intended use changes. The Impr
the Laws and Rules for Sewage Treatment and Disposal and to conditions of this permit..
SEE ATTACHED SITE SKETCH
permits. The permit hol er is r ponsible for checking with appropriate governing bodies in meeting their requirements. This
Permit shall not be affected by a change in ownership of the site. This permit is subject to compliance with the provisions of
Construction Authorization
(Required for Building Permit)
The construction and installation requirements of Rules .1950, .1952, .1954, .1955,
with the attached system layout .1956, .1957, .1958. and .1959 are incorporated by references into this permit and shall be met. Systems shall be installed in accordance
ISSUED TO: t tb w PROPERTY LOCATION: M q-'~,s SUBDIVISION Ps~EFO~~ LOT # ~ )
Facility Type: S~6~xus-I New ❑ Expansion ❑ Repair
Basement? ❑ Yes No Basement Fixtures? ❑ Yes XNo
Type of Wastewater System- -"6°f o ~e~vc.S '0 ',J ysTG rn (Initial) Wastewater Flow: L }gd
(See note below, if applicable GPD
45% Rau s0 'J Sy C£ (Repair)
Installation Requirements/Conditions Number of trenches 3
Septic Tank Size t boa gallons Exact length of each trench --70 feet Trench Spacing:
Pump Tank Size gallons Trenches shall be installed on contour at a Soil Cover. _ Feet on Center
inches
Maximum Trench Depth of. 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. TDH vs. GPM
inches below pipe
WAS }_~r, _
Conditions: p~ Aggregate Depth: inches above t e
~ G Mv~ UG 10 ~ru~r~ S~p-CtG Sys-C.r-~ o PP
MPsi L ota,~a Oti, , 5~{~y inches total
.J o0 e-E1(`CM2
*'`If applicable: /understand the system type specified is different from the type speci>ed as the app/ication. / accept the rpecificationr of this permit
Owner/Legal Representative Signature:
Date:
This Construction Authorization is subfe cat on if the site plan, plat or the intended use changes. The Construction Authorization shall not be transferred when there is a change m ownership of the site. This
Construction Authorization is s compli wi visions o e laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent: Date: 5 k-1
Authorization Expiration Date:
HTE# O- S-1' 40 Permit # °1(-bL15
Harnett County Departinent of ll~lblic Health
Site Sketch
ISSUED T0:
w n (ji5
PROPERTY LOCATON:
SUBDIVISION
LOT #
Authorized State Agent:
Date:
5 ~-l 10
WC
tOd