IPAC RRHTE# 4C)-fS`)3-y5L4 F, LZ Harnett County Department of Public Health 2 6 0 4 6
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: "w 11-a. Nj
ISSUED T0: ~fn~CL~ Py ~ntr~G5M1~~1 SUBDIVISION -,"Gg.ty; Ph t LOT # "R l
NEW REPAIR E)(NSION 11 Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: SF p 3r, ~x
Proposed Wastewater System T pe:
Projected Daily Flow: 3~0 GPD
Number of bedrooms: Number of Occupants: max
Basement ❑Yes No
Pump Required: ❑Yes ❑ No lay be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community X Public ❑ Well Distance from well M 0 feet Permit valid for Five years
Permit conditions: ❑ No expiration
Authorized State Agent:: Date: 5 Vzl SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the issuance o permits. The permit holder is res osible for checking with appropriate governing bodies in meeting their requirements. This
site is subject to revocation 4 the site plan, plat, or the intended use changes. The Improvement ermit 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
with the attached system layout
into this permit and shall be met. Systems shall be installed in accordance
ISSUED T0: PROPERTY LOCATION: ~~hct
~'~Vl
SUBDIVISION LOT #
Facility Type: N
❑ E
i
ew
xpans
on ❑ Repair
Basement? El Yes No Basement Fixtures? El Yes -~<No
Type of Wastewater System** ~.5% ~gycsS v(3 r ` 5 ~►J~~ L~2Fh~ p(L
(Initial) Wastewater Flow: C GPD
(See note below, if applicable
W10Q~U) - S -)s - ~,hvs G~Lt2p~ 0a- (Re
air)
p
Installation Requirements/Conditions Number of trenches 1
Septic Tank Size t:t00
gallons Exact length of each trench VC) feet
C
Trench Spacing: ~ feet on Center
Pump Tank Size gallons Trenches shall be installed on contour at a
Soil Cover inches
Maximum Trench Depth of. a 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
Conditions: l,~ tU t pC C=ovF l 2EG
S
inches below pipe
Aregate Depth: inches above pipe
J ~Q'60 OV IFQ- \4°~ 6~2- inches total
In11 ntv~~ r> ~h1 ~nreos
BEr ~~CQct 7S 0 s L_G~C t itV"~
**If applicable: / understand the system type specified is different from the type specified on the app/ication. / accept the specifications of this permit
Owner/Legal Representative Signature: Date:
This Construction Authorization is subject to revo _ the site lot 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 's sub' ct to complia ith ronsi the and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent:
Date: 5 1,3 10
Construc orization Expiration Date: S~
HTE# O 5 a~`1 5Li j21D, Permit #
Harnett County De t-ti-tmellt of f'tlblic Health
ite ketch
PROPERTY LOCATON: ~w y `~,`l \
ISSUED TO: SUBDIVISION I s N E 1N~ G LOT #
Authorized State Agent ~ (,6 L-A4 - 0 L's,' Date: 1
In i,
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