IPAC$ 2104
HTE# 0 -5 -3~ Harnett nountY Department of Public Health
Imurovement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: N
ISSUED TO: Cv r^~C~Ll_
P+Np Worms
SUBDIVISION M a u.t Qxz.t Nc->A LOT # Lifo
NEW>< REPAIR ❑
EXPANSION ❑
Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: S~ O ~S n -,5 S~)
Proposed Wastewater System Type:
3
F' U cre-Vo Ccz N-4ej l
[ t o N A L,
0
Projected Daily Flow:
GPD
Number of bedrooms: 2>
Number of Occupants:
max
Basement ❑Yes )~<No
Pump Required:-'Res ❑ No
❑ May be required based on
final location and elevations of facilities
Type of Water Supply: ❑ Commun
ity X Public ❑ Well
Distance from well ~O(Z) feet Permit valid for. X Five years
Permit conditions:
❑ No expiration
Authorized State Agent:: Qbh5 Date: 51"*t1 CQ SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the issuan er permits. The permit hold is re ponsible 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 Improvemen Permit 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, AS6, .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: Cu.rn6Ecui-p-jo Ao~C--S PROPERTY LOCATION: W
SUBDIVISION M \ a4-- b Q-P, LOT # 4(6
Facility Type: SAO'`'3~~ New ❑ Expansion ❑ Repair
Basement? ❑ Yes No Basement Fixtures? ❑ Yes X No
Type of Wastewater System** Pv cn'F-7o C-<) ~vv~v7 to c-, N1- (Initial) Wastewater Flow: 3CO GPD
(See note below, if applicable
pv rnP-Do (::0 NV I~NT U N AL (Repair)
Installation Requirements/Conditions Number of trenches LA
Septic Tank Size LOGO gallons Exact length of each trench SO feet Trench Spacing: cl Feet on Center
Pump Tank Size 1-Oo o gallons Trenches shall be installed on contour at a Soil Cover. \a= inches
Maximum Trench Depth of: 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 C inches below pipe
A regate Depth: a. inches above pipe
Conditions: ~DCCC-~- Ny vs~ 10 ~ttQr„ S~~\c~S~Is-E,n- ci 13 inches total
~1L\ \~S l *(~c~ACki \ / ~ws.CtR nn DS>\n_ Gtr
**If applicable: / understand the system type speciFed it different from the type specified on the app/ication. / accept the roeciflwionr of this permit
Owner/legal Representative Signature: Date:
This Construction Authorization is subject to revocation if the site plan, plat, or the intended use changes. The Construction Authorization shall not be transferred when there is a chancre in ownershiD of the site. This
Construction Authorization is
the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit
SEE ATTACHED SITE SKETCH
Authorized State Agent: p3-,-) Date: 5 ~40
o uction Authorization Expiration Date: 5 [d6 a5
H T E # 10`A9 Permit #
Harnett County I lepartment of Public Health
site Sketch
PROPERTY LOCATON: NG30
ISSUED T0: C u re) w.No ~aMFS SUBDIVISION t"l.ab LOT #
Authorized State Agent Ss wry ~o~rsoo Date:C i a
i