IPAC RHTE# - � Z Harnett County Department of Public Health 27865
hDrovement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION:
ISSUED T0:-5 SUBDIVISION LOT #_
NEW ❑ REPAIR ❑ EXPANSION Site I provements required prior to Construction Authorization Issuance:
Type of Structure: /--s SE3
Proposed Wastewater System Type: Z51/6 QPrW C
Projected Daily Flow: GPD
Number of bedrooms: Number of Occupants: ,max
Basement ❑Yes 2°No
Pump Required: ❑Yes ❑ No VIM,, be required based on final location and elevations of facilities
Type of Water Supply: El Community Public ❑ Well Distance from well feet Permit valid for: 91 Five years
Permit conditions: ❑ No expiration
Authorized State Ag t:: Date: `'1— Zvi — I `1 SEE ATTACHED SITE SKETCH
The issuance of this permit by th, Ith Department in no way guarantees t 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 th to 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 TO: 1 t �� JPROP RTY LOC ATION: ISION LOT # Facility Type: t t ❑ New Expansion Repair
Basement? ❑ Yes No Basement Fixtures? ❑ Yes I� No
Type of Wastewater System ** "1A0 f26i�V au (Initial) Wastewater Flow: _ A 0 GPD
(See note below, if applicable ❑)
t; e-- 7 (Repair)
Installation Requirements /Conditions Number of trenches 12
Septic Tank Size ° allons Exact length of each trench ) S feet Trench Spacing: Feet on Center
.
Pump Tank Size allons Trenches shall be installed on contour at a Soil Cover: inches
Maximum Trench Depth of: !. ? I 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: /2--, inches total
WATER LINES (INCLUDING IRRIGATION) MUST BE IOFT. FROM ANY PART OF SEPTIC SYSTEM OR REPAIR AREA.
NO UTILITIES ALLOWED IN INITIAL OR REPAIR DRAIN FIELD AREA.
* *If applicable: l understand the system type s)o ied is different from the type speciFed on the application. l accept the specifications 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 Age t: Date: s--& - Z f
Construction Authorization Expiration Date:
HTE # 3322 5 Permit # .2-7
Harnett County ]Department of Public Health
Site Sketch
PROPERTY LOCATON:
ISSUED TO: -p SUBDIVISION LOT #
Authorized State Age : Date:
"'13
C'` / /4
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