IPAC RHTE# X g Va14 Harnett County Department of Public Health 2 616 3
Imarovement Permit
A building permit cannot be issued with only an Improvement ermrt /
PROPERTY LOCATION: -
ISSUED
ISSUED T0: _ orb k S. c~~, SUBDIVISION c1..+ 5 C>~=C.IItf,~. LOT # Z
NEW 2 REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: J- -7i
Proposed Wastewater System Type: _C-~~ZtI ck
Projected Daily Flow: 13 _ GPD
Number of bedrooms: Number of Occupants: max
Basement ❑Yes
Pump Required: ❑Yes ❑ No 12'b e required based on final location and elevations of facilities
Type of Water Supply: ❑ Community Public ❑ Well Distance from well feet Permit valid for: Five years
Permit conditions: ❑ No expiration
Authorized State Agent:: //.~..~n•, yr N /IV Date: ~8 mow SEE ATTACHED SITE SKETCH
The issuance of this permit by thf4ealth artment 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. j
ISSUED TO: PROPERTY LOCATION: (11-o,11 ham.
~ SUBDIVISION 3 Li: LOT # Z
Facility Type: 21/New ❑ Expansion ❑ Repair
Basement? ❑ Yes 2"-No Basement Fixtures? ❑ Yes ❑ No
Type of Wastewater System' C c,t t!"~ c (Initial) Wastewater Flow: -7 GPD
(See note below, if applicable
k N-Q- (Repair)
Installation Requirements/Conditions Number of trenches
Septic Tank Size /c'OC) gallons Exact length of each trench L~-b feet Trench Spacing: Feet on Center
Pump Tank Size gallons Trenches shall be installed on contour at a Soil Cover: (.-1.2, inches
Maximum Trench Depth of. Z8 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: -Z inches above pipe
Conditions: l;t_ inches total
` r1 pt".- r- ~✓l~ Cwf C.Y:Jq. 6 >...~.r 0. 1.,'4 L CET mv. (`i.ti
'*If applicable: /understand the system type specified is different from the type specified on the application. / accept the spec1)1rcat1on5 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: C c` ~'11f Date: ,2oi c
Construction Authorization Expiration Date: ~.zufr
HTE# A) - 3' ZYq Z( Permit # a2~ l k. 3
Harnett Colinty Department of 1' blic neaw,
Site ketch
PROPERTY LOCATON: G-"~ ~ "
ISSUED T0: S. M e,l SUBDIVISION
LOT #
Authorized State Agent: Date: 2~ t C3
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