IPAC RHTE# t Harnett County Department of Public Health 27771
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
t PROPERTY LOCATION: 4A\,J SpLt",.4 LN
ISSUED TO: Z� L(L1 SUBDIVISION LOT #
NEWN, REPAIR ❑ E PANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: V1 9 V\0 K'-' -
Proposed Wastewater System Type: REtavc, , oN YSE t�
Projected Daily Flow: 3 E,® GPD
Number of bedrooms: Number of Occupants: max
Basement ❑Yes X No
Pump Required: ❑Yes No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community '`2� Public ❑ Well Distance from well l (!9 O feet Permit valid for `Five years
Permit conditions: ❑ No expiration
Authorized State Agent::
The issuance of this permit by the Health Department in no way guarantees the issuance of o
site is subject to revocation if the site plan, plat, or the intended use changes. The Improvement
the Laws and Rules for Sewage Treatment and Disposal and to conditions of this permit..
Date: t 113114 SEE ATTACHED SITE SKETCH
The permit holds is res onsible for checking with appropriate governing bodies in meeting their requirements. This
ill not be affected by a change in ownership of the site. This permit is subject to compliance with the provisions of
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 T0: PROPERTY LOCATION:
SUBDIVISION LOT #
Facility Type: "p,,.t ��acrC ��U` GX New ❑ Expansion ❑ Repair
Basement? ❑ Yes � No Basement Fixtures? ❑ Yes N
Type of Wastewater System ** ��"la v G°s .� `� (Initial) Wastewater Flow: O GPD
(See note below, if applicable ❑)
2L'5 1®
Q—k O y GT 10 ) C. u m� (Repair)
Installation Requirements /Conditions
Number of trenches I+
Septic Tank Size 10 c)O gallons
Exact length of each trench 1 feet
Pump Tank Size gallons
Trenches shall be installed on contour at a
Maximum Trench Depth of. inches
(Trench bottoms shall be level to +/ -1/4"
in all directions)
Pump Requirements: ft. TDH vs.
GPM
Conditions:
Trench Spacing: C) Feet on Center
Soil Cover: (--- l'i inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
Aggregate Depth:
WATER LINES (INCLUDING IRRIGATION) MUST BE IOFT. FROM ANY PART OF SEPTIC SYSTEM OR REPAIR AREA.
NO UTILITIES ALLOWED IN INITIAL OR REPAIR DRAIN FIELD AREA.
inches below pipe
inches above pipe
inches total
* *If applicable: / understand the system type specified is different from the type specified on the app lication. / accept the speciTcations of this permit
Owner /Legal Representa ' ature: Date:
This Construction Author ti - subject to rev the site p t 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 s liance with ro he and Rules for Sewage Treatment and Disposal and to the conditions of this permit. SEE ATTACHED SITE SKETCH
Authorized State Agent: Date: 13
Constru uthorization Expiration Date: —
HTE# I3-5-- 'a UGOQ_ Permit # ZY1 -)
Authorized State Age 1-1 �V&?- 7-0 �j QY Date: %1131)4
M-I.
To SNVI(%C/NL?i
1'