IPAC RRHTE# U9- s= X:53 /we x Harnett County Department of Public Health 2 61 5 4
Improvement Permit
A building permit cannot be issued with only an I provement T Pit
PROPERTY LOCATIO : / f / . ~-t
ISSUED T0: / I 1 SUBDIVISION _ e~ ~Jef ~cs~acn LOT #
NEW C~ REPAIR EXPANSION F-1 Site Improvements required prior to Construction Authorization Issuance:
5Z
Type of Structure: D
~
Proposed Wastewater System T pe: ~ . c,,,t O'e, It;t
Projected Daily Flow: GPD
Number of bedrooms: Number of Occupants: max
Basement ❑Yes ' YNo
Pump Required: fifes ❑ No ❑~Ma~be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community lyf Public ❑ Well Distance from well feet Permit valid for i?-five years
Permit conditions: ❑ No expiration
Authorized State Agent:: Date: 4 SEE ATTACHED SITE SKETCH
The issuance of this permit by the alth Department in no *7 1-tees 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, plat, 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 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
into this permit and shall be met. Systems shall be installed in accordance
with the attached system layout tt
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ISSUED T0:
(
c^r PROPERTY LOCATION:
4// = t
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Facility Type:
~ SUBDIVISION
e- -New ❑ Expansion ❑ Repair
LOT #
Basement? ❑ Yes No Basement Fixtures? ❑ Yes ❑ No
T
e of Wastewater S
pt ~c
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(Initial) Wastewater Flow: 70 GPD
(See note below, if applicable
F7- (Repair)
Installation Requirements/Conditions
Number of trenches l
Septic Tank Size ~/6W gallons
Exact length of each trench 4Z.o feet
Trench Spacing: c/ Feet on Center
Pump Tank Size ad gallons
Trenches shall be installed on contour at a
Soil Cover. 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
inches below pipe
nditionCCA L
-J E c P~< c 4~ n5 t~ ~~e J-
A regate Depth:
inches above pipe
/
inches total
/
*If applicable: l understand the system type specified /s dif/erent /ram the type speti6ed on the app/ication. /accept the rpeci6cations 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 change in ownership of the site. This
construrnon Authorization is subject to compliance with the provisions of the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Age Date: G z~ _
Construction Authorization Expiration Date: A 4 d
HTE#
Harnett county
Permit # 2 ( 1.5--T
Depailittent of I--~ibl i c Health
Site Sketch
PROPERTY LOCATON:
ISSUED TO: r z" lj t,--f SUBDIVISION LOT #
Authorized State Agent: ~Zl Date: 6 / 2'0
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