IPAC RHTE #Q 5 v �)3a:7.59, Harnett County Department of Public Health 27774
Improvement Permit
A building permit cannot be issued with only aRy�Improvement Permit
PROPERTY LOCATION:
ISSUED TO: �' i-Z - t-�a�- V \b s,`, SUBDIVISION Cg NS LOT # �z
NEW M REPA R ❑ r PANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: S �yu -�L, %�
Proposed Wastewater System Type: o 0" 'j yS s *tom
Projected Daily Flow: d GPD
Number of bedrooms: 3 Number of Occupants: �' max
Basement ❑Yes XNo
Pump Required: ❑Yes No El be required based on final location and elevatio of facilities
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Type of Water Supply: ❑ Community Public ❑ Well Distance from well )0 feet Permit valid for 'Five years
Permit conditions: ❑ No expiration
Authorized State Agent:: qj��
The issuance of this permit by the Health Department in no way guarantee nce
site is subject to revocation if the site plan, plat, or the intended use changes. The fftv
the Laws and Rules for Sewage Treatment and Disposal and to conditions of this permit..
b Date: N 11411 4i SEE ATTACHED SITE SKETCH
of other permits. The permit hol r is r sponsible for checking with appropriate governing bodies in meeting their requirements. This
vT ent Permit shall 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 TO: 12-1 1 '-2 -- �t- �`���- ��t s" -S PROPERTY LOCATION: 9LNZC4? -0
SUBDIVISION �� -i�S� ��•�ar�S LOT #
facility Type: ����x�� New ❑ Expansion ❑ Repair
Basement? ❑ Yes No Basement Fixtures? ❑ Yes ) l No
Type of Wastewater System ** n R-Co U C,°c l 4 N'4 C -/s r (Initial) Wastewater Flow:3 J GPD
(See note below, if applicable ❑)
e� S /t# - DU'C--S't 0W (Repair)
Installation Requirements /Conditions Number of trenches �k'
Septic Tank Size , gallons Exact length of each trench 5 feet Trench Spacing: c�) feet on Center
Pump Tank Size gallons Trenches shall be installed on contour at a Soil Cover: inches
Maximum Trench Depth of: 1-3(o 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
Aggregate Depth:
Conditions:
WATER LINES (INCLUDING IRRIGATION) MUST BE ]OFT. 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 application. / accept the speciTcations 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 ownershin of the site. Thk
Construction Authorization is subject to �,omplian r she„pro�h'9��of the laws and Rules for Sewage Treatment and Disposal and to the conditions of this
Authorized State Agent: Date: S j
uction Authorization Expiration Date: 1 `
SEE ATTACHED SITE SKETCH
H T E # 0c) . 5- 5 P—
Permit # 1+
Harnett County Department of Public Health
Site Sketch
PROPERTY LOCATON:
ISSUED TO: ?s SUBDIVISION LOT#
Authorized State Agent: V-C—'M I - I V�L- 10 L�: 1 Date:
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