IPACHTE# iD -s-a41i oL Harnett County Department of Public Health 2 6 0 4 4
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
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PROPERTY LOCATION: M os2,r, y Q ry
ISSUED T0:
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SUBDIVISION _ AS>~=Fo
LOT # ~a
NEW
REPAIR E
~ MANSION ❑
Site Improvements required prior to Construction Authorization Issuance:
Type of Structure:
5
P
roposed Wastewater
System T e: ~ oy r✓' ~C9 N
Sy t j cry
Projected Daily Flow:
GPD
N
umber of bedrooms:
Basement ❑Yes
Number of Occupants:
No
max
Pump Required: ❑Yes
❑ No XMay be required based on
final location and elevations of faciliti
Type of Water Supply:
P
❑ Community Public ❑ Well
es
Distance from well 1C~~7 feet
Permit valid for: Five years
ermit conditions:
❑ No expiration
Authorized State Agent:: Date: 5 116 1(7 SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the issuance er permits. The permit hol r is r sponsible 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 mit 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: a W V,-,c D ~u~Lo S ~L C - PROPERTY LOCATION: MPca~~ Q~
SUBDIVISION P,o -r-VoQ LOT #
Facility Type: S'ED ( 5C A1400 New ❑ Expansion ❑ Repair
Basement? ❑ Yes No Basement Fixtures? ❑ Yes XINo
Type of Wastewater System** (Initial) Wastewater Flow:_ GPD
(See note below, If applicable
o9J°1o P\EDUc;N 16 0 :5yS-tEV\ (Repair)
Installation Requirements/Conditions Number of trenches 1 c,
Septic Tank Size I o o d gallons Exact length of each trench a0 0 feet Trench Spacing: 1 feet on Center
Pump Tank Size gallons Trenches shall be installed on contour at a Soil Cover. - inches
Maximum Trench Depth of. 14"~1-14 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 inches below pipe
Conditions: O~ S Jggre a e Depth: inches above pipe
(~It ~'C- vs-sr tL- J1 5 inches total
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**If applicable: /understand the system type specified it different from the type rpeci6ed on the app/ication. /accept the specifications of this permit.
Owner/Legal Representative _Si nature: Date:
This Construction Authorization is subject to revoca Elan, plat a intended use changes. The Construction Authorization shall not be transferred when there is a change in ownership of the site. This
Construction Authorization is su ' t t -fiance wit 92!15 e laws les for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent: Date: 5 1x G
Construction Au rization Expiration Date: 5 )i ~
HTE# 10-5- aL}~ Permit #
Harnett County Depa ment of I'liblic Health
Site Sketch
c~ PROPERTY LOCATON: ~cz~,t,S Rp
ISSUED T0: HO DV~La LLL SUBDIVISION LOT #
(o ~.v ca i OLY-so oct ~
Authorized State Agent EIS Date:
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