IPAC RHTE# b'7-,5n--1 f 22P, Harnett County Department of Public Health 2 5 5 2 5
Improvement Permit
A building permit cannot be issued with only an Improvement Pe
PROPERTY LOCATIQN: P.nc, 4-
ISSUED TO: SUBDIVISION ~--r nA- 2 LOT #
NEW "10„ REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: 5 F O X,,R J
Proposed Wastewater System Type:
ny a
Projected Daily Flow: g`. GPD
Number of bedrooms: Number of Occupants: 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 El Well Distance from well O,~ feet Permit valid for. Five years
Permit conditions: (u " u vvr~~J~h ~p \ e,.f c/ Yx-f- ❑ No expiration
OnA%v\A'A c ~ F1~k 1~_ 3t AP- ( scf nA~ r cJ
Authorized State Agent:: f t J F%FS Date: LIF 7 4- I D SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health epartment 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 taws 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: z PROPERTY LOCATION:
SUBDIVISION ut'rn_1` (fit lr~ LOT #
Facility Type: k t5 311 (Z ~9 New ❑ Expansion ❑ Repair
Basement? ❑ Yes `4 No Basement Fixtures? ❑ Yes No
Type of Wastewater System** C--,"r t:3 A l (Initial) Wastewater Flow: `2 GPD
(See note below, if applicable A)
L-y' P lei? A 2 (Repair)
Installation Requirements/(onditions Number of trenches --I
Septic Tank Size _ loop gallons Exact length of each trench dc`s feet
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of: inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
Pump Requirements: ft. TDH vs. GPM
Conditions:
Trench Spacing:_ Feet on Center
Soil Cover Cs inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
Aggregate Depth:
IS inches below pipe
Z inches above pipe
12_ inches total
**If applicable: /understand the system ty pe specified is different from the type specified on the application. /accept the specdcationr of this permit
Owner/Legal Representative Signature: Date:
Thit (nn<frvveinn Eurhariv~6nn „6~e.e a , ,.i__ -r..
- 1- ° °11 r•_,., r° ,,,.1,,,._„ _ = a x . mnuauimr nuurunuauun snap not oe transterrea when there is a change in ownership of the site. This
~uusuucuuu numonranun is suofeea 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:
Construction Authorization Expiration Dater - -U i S~
NTE# D~7 -533- IG .QPR Permit # 9ss)- 5-
Harnett ( `onnty Department of 1-i blic Health
Site Sketch
PROPERTY LOCATON: (2a(nk
ISSUED TO: SUBDIVISION ,C e r A ate-'.` LOT #
Authorized State Agent: Date:
,v c .a
Sp- a 5.-~
ti
~Z)
~s
t ~
,S
i
v" a
~u 4 Y
i
1-n ,f p, 00' Deep
~ ~ rL
7 t-l a cr n c