IPACHTE#/0-r- ;L C/ y/ j Harnett County Department of Public Health 2 5 9 7 8
Improvement Permit
_ A building permit cannot be issued with only an Improvement Permit
ISSUED T0: m ~ PROPERTY LOCATION: yo 6
`4_,_ jr- SUBDIVISION Q ~ N
EW [I REPAIR EXPANSION ❑ LOT #
Site Improvements required prior to Construction Authorization Issuance:
, f F
Type of Structure: (E 2 IR f ~
Proposed Wastewater System Type: °4 ti :~,t SZ
Projected Daily Flow: ~C G GPD
Number of bedrooms: -7 Number of Occupants: C- max
Basement ❑Yes 13'90
Pump Required: ❑Yes ❑ No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community B'i ublic ❑ Well Distance from well JG feet
Permit conditions: Permit valid for: B'Five years
❑ No expiration
Authorized State Agent:
Date: .S SEE ATTACHED SITE SKETCH
The issuance of this permit by t ealth Department in no way guarantees the issuance of other permits. The permit holder is responsible for checking with appropriate governing bodies in meeting their requirements. This
site is subject to revocation if the site plan, pla4 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 prorisions of
the Laws and Rules for Sewage Treatment and Disposal an d to conditions of this permit..
Construction Authorization
(Required for Building Permit)
The construction and installation requirements of Rules .1950, .1952, .1954, .1955, .1956, .1951, .19S8. 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 T0: } caM u l~ PROPERTY LOCATION:
Facility Type:
Basement? ❑ Yes ❑ No
Type of Wastewater System"
(See note below, if applicable
SUBDIVISION LOT #
❑ New ❑ Expansion Repair
Basement Fixtures? ❑ Yes ❑ No
Installation Requirements/Conditions (Repair)
Number of trenches
Septic Tank Size C ~-f-t gallons Exact length of each trench S-0 feet
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of. 3(- inches
(Trench bottoms shall be level to +1-114"
in all directions)
Pump Requirements: ft. TDH vs. GPM
(Initial) Wastewater Flow: GPD
Trench Spacing: Feet on Center
Soil Cover: % inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
Conditions: c e_" m c- 4, Aggregate Depth:
{c (cep(: 'C ~~wee 4-Z
C- u,
C inches below pipe
inches above pipe
f ~2, inches total
**If applicable- l underrtand the ryrtem type .rpecired it different from the type rpeci6ed on the application. /accept the rpeciFcationr of thir permit
Owner/Legal Representative Signature:
This Construction Authorization is subject to revocatio71h e plan, pla4 or e ntendd use angesThuctioAuthorization hlcondmb.'uf ansfrrd when Deareege in ownership of the
on Authorization siteThis
Construcibject to cpliance wvisions of the fawn and Rules for Sewage Treatment and Disposal and to the this perm' SEE ATTACHED SITE SKETCH
Authorized State Agent: f Date: 5 f 4,01c"
Construction Authorization Expiration Date: ?c 2ci~`
HTE# `j78
Permit #
Harnett County Department of 11W)lic Health
Site ketch
PROPERTY LOCATON:
ISSUED TO: C v SUBDIVISION
LOT # Z
Authorized State Agent: G=~~f
Date: S Zc 2~l c
04- IA<
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