IPAC RHTE#
Harnett t ount Department 2 612 6
y of Public Health
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY
ISSUED TO: Ft "a _'V10V G C---q - Co 2P LOCATION: 1-x .5 y ai-}
SUBDIVISION N4ct uA..Es sS2no,pg LOT # roZJ
NEWX, REPAIR ❑ EXPANSION Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: Mii~N ,Koc a'(5 x~ C5
Proposed Wastewater System Type: 15Va KG-ovco;~N o N 5751-61..
Projected Daily Flow: L-) GPD
Number of bedrooms: 1--i Number of Occupants: g max
Basement ❑Yes ~ No
Pump Required: ❑Yes ❑ No May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community Public ❑ Well Distance from well 100 feet IN/r
Permit conditions: Permit valid for Five years
~ ❑ No expiration
Authorized State Agent:: 2&V\5 Date: IN It The issuance of this permit by the Health Department in no way guarantee!the ce other permits. The permit holder is responsible for checking with appropriate governingSodieArnAmHED ShTE egETements. 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
with the attached system layout
ISSUED TO: P1 N E G v z Q Gw Cdak PROPERTY LOCATION: I~w
SUBDIVISION o.~ u c~,6 s
Facility Type: MAr4 ,'AdME 30'~l6 1< New ❑ Expansion ❑ Repair
Basement? ❑ Yes _ No Basement fixtures? ❑ Yes 3Y Type of Wastewater System** as°lo 0.~pvL-~v f Sy~T
(See note below, if applicable
into this permit and shall be met. Systems shall be installed in accordance
r,-Ll
Ca assRgo~pg -LOT # (~O
_ (Initial) Wastewater Flow: 14'~d GPD
a.S`t/o Q'&9 yyS r (Repair)
Installation Requirements/Conditions Number of trenches I
Septic Tank Size ~Qc) gallons Exact length of each trench s-t00 feet Trench Spacing: Pump Tank Size gallons Trenches shall be installed on contour at a Soil (oven: Feet on Center
inches
Maximum Trench Depth of. Vq inches (Maximum soil cover shall not exceed
(Trench bottoms shall be level to +1-114" 36" above the trench bottom)
in all directions)
Pump Requirements: ft. iDH vs. GPM
inches below pipe
Conditions: A-CC L Aggregate Depth: inches above pipe
.Ns rf\US-~ l ,6 l0 '~P"aorr SEiPl~ 1C.
l}~~L-s-~' t4)P I PvCN, opt ~Njj-C)fl.L a Aft inches total
**If applicable: / underrtand the system type speciled is different from the type specified on the app&ation. / accept the specilcmionr of this permit,
Owner/legal Representative Signature:
Date:
This Construction Authorization is subject to revo if the site pla la( or the intended use changes. The Construction Authorization shall not be aansferred when there is a change in ownership of the site. This
Construction Authorization is su 'ect to compliance wit the p of t aws and Rules for Sewage Treatment and Disposal and to the conditions of this permit.
p SEE ATTACHED SITE SKETCH
Authorized State Agent: ~ S Date: 6 a~ 10 Constru ' Authorization Expiration Date: t t iS
HTE# Permit # }~-r,
Harnett County Depailinent of ~:'><lblic Hetalth
Site Sketch.
PROPERTY LOfATON:_
ISSUED T0: G¢ c3v L t-4 , 0.e SUBDIVISION t~ P.. v2Es Crros~~~ q LOT #
Authorized State Agent:5 c~avE~, Date:
'Cap-K~~ors
~S
1~3
arc'
g4y1v
v>