IPACHTE #- 323o y Harnett County Department of Public Health 27728
Improvement Permit
Authorized State Agent:: Date: SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health 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, 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, .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: CA, i t _ PROPERTY LOCATION: , 157` IVA-
,mzva V P IZ. *
SUBDIVISION LOT #
Facility Type: t 'IL `��" El New Expansion ❑ Repair
Basement? ❑ Yes ❑ No Basement FrF1'xtures? ❑ Yes ❑ No
Type of Wastewater System ** 6 �?U (Initial) Wastewater Flow: GPD
(See note below, if applicable ❑) �
(Repair)
Installation Requirements/Conditions Number of trenches
Septic Tank Siz t gallons Exact length of each trench °®' feet Trench Spacing: Feet on Center
Pump Tank Size 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
Aggregate Depth: inches above pipe
Conditions: ,J i� —� , inches total
WATER LINES (INCLUDING IRRIGATION) MUST BE LOFT. FROM ANY PART OF SEPTIC SYSTEM OR REPAIR AREA.
NO UTILITIES ALLOWED IN INITIAL OR REPAIR DRAIN FIELD AREA.
*If applicable: /understand the ryrtem type .rpeciled it different from the type rpeciled on the application. /accept the specipcationr 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
Construction 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 Agent: - Date: 6
Construction Authorization Expiration Date:
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: �!r Y � t4
0P6 '�'"' (- �
ISSUED T0:
SUBDIVISION
LOT #
NEW ��K
REPAI ❑
EXPANSION
Site Improvements required prior
to Construction Authorization Issuance:
Type of Structure:
ko
0 A4,H
Proposed Wastewater System Type:
_ ^�
Projected Daily Flow:
°'°'
GPD
Number of bedrooms:
Number of Occupants:
°°`" max
Basement ❑Yes
31'o
Pump Required: ❑Yes
❑ No
❑ May be required basd
on final location and elevations of facilities
Type of Water Supply:
El Community
El Public L_�I Well
Distance from well feet
�-
Permit valid for: L2'f the years
Permit conditions:
❑ No expiration
Authorized State Agent:: Date: SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health 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, 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, .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: CA, i t _ PROPERTY LOCATION: , 157` IVA-
,mzva V P IZ. *
SUBDIVISION LOT #
Facility Type: t 'IL `��" El New Expansion ❑ Repair
Basement? ❑ Yes ❑ No Basement FrF1'xtures? ❑ Yes ❑ No
Type of Wastewater System ** 6 �?U (Initial) Wastewater Flow: GPD
(See note below, if applicable ❑) �
(Repair)
Installation Requirements/Conditions Number of trenches
Septic Tank Siz t gallons Exact length of each trench °®' feet Trench Spacing: Feet on Center
Pump Tank Size 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
Aggregate Depth: inches above pipe
Conditions: ,J i� —� , inches total
WATER LINES (INCLUDING IRRIGATION) MUST BE LOFT. FROM ANY PART OF SEPTIC SYSTEM OR REPAIR AREA.
NO UTILITIES ALLOWED IN INITIAL OR REPAIR DRAIN FIELD AREA.
*If applicable: /understand the ryrtem type .rpeciled it different from the type rpeciled on the application. /accept the specipcationr 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
Construction 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 Agent: - Date: 6
Construction Authorization Expiration Date:
HTE # '14 — — 3-7— i !
Permit # 2- -Z
Harnett County Department of Public Health
Site Sketch
PROPERTY LOCATON: /57 q Mi+yyi : r ki i, CGw,t
ISSUED TO: '? K SUBDIVISION LOT #
Authorized State Agent: 441 /� �� Date: l7
AOL
6
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