IPAC RHTE# Harnett County Department of Public Healtn
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: A--' "i:)ctw C
ISSUED TO: 5y6.'5 1 rJ 1-� SXCLC -U rN SUBDIVISION Voss Mc.Q P,c aaP.E LOT #
NEWX REPAIR ❑ EXISION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: SC= p (ro5 A!r°
Proposed Wastewater System Type: vE N C so cv 1;1-,L-
Projected Daily Flow: D +�
Number of bedrooms: Number of Occupants: 9 max
Basement ❑Yes XNo
Pump Required: ❑Yes No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community Public ❑ Well Distance from well X00 feet Permit valid for: ,Rive years
Permit conditions: ` ❑ No expiration
Authorized State Agent:: —N ��\ ii.E�S Date: ���i lam_ SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the issua other permits. The permit holderf is re onsible for theca h appropriate governing bodies in meeting their requirements. This
site is subject to revocation if the site plan, plat, or the intended use changes. The Improvem tt Permit shall not be affected by a c owners ' the s . is permit is subject to compliance with the provisions of
the Laws and Rules for Sewage Treatment and Disposal and to conditions of this permit.. .,l
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: J uslNr'r \- i.srnL,U PROPERTY LOCATION: -2>t2.P,6 SipwE
SUBDIVISION ?' os5 r'4 -ZP'S LOT #
Facility Type: 5 ��� '`' �! New ❑ Expansion ❑ Repair
Basement? ❑ Yes >Z\ No Basement Fixtures? ❑ Yes No
Type of Wastewater System ** t�i:f� -' rw� . c v�lz� >) NOQ (Initial) Wastewater Flow: GPD
(See note below, if applicable ❑) g 'fib L, 6 0
''3 ��(Repair)
Installation Requirements /Conditions Number of trenches a
Septic Tank Size tiCOO 0 gallons
Pump Tank Size gallons
Pump Requirements: ft. TDH vs.
Conditions:
Exact length of each trench 1S- feet
Trenches shall be installed on contour at a
Maximum Trench Depth of. R -3 �— inches
(Trench bottoms shall be level to +/ -1/4"
in all directions)
GPM
Trench Spacing: 9 Feet on Center
Soil Cover: C-a-') inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
inches below pipe
gate Depth: inches above pipe
1- inches total
* *If applicable: l understand the system type specified is different from the type specified on the application. / accept the specifications of this permit.
Owner /Legal Representative Signature: Date:
This Construction Authorization is subject to revoc t if the site plan, ,pplat, 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 subje�te�mpliance ht s Io ` Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit. SEE ATTACHED SITE SKETCH
Authorized State Age
Q2C °vl "J
Date: 6
Authorization Expiration Date:
HTE# I C-) —5 -2a, -4 R, Permit # 1� l nt
Harnett County Depailinent of FVblic Health
Site Sketch
ISSUED TO:
Authorized State Agent:
�S6D C1 2s&
15_7.
PROPERTY LOCATON:
SUBDIVISION R ®mss ne c F LOT #
.v
Z50 j
j �I10