IPACHTE# ~o- 2gL16z Harnett County Department of Public Health 26176
Improvement Permit
A building permit cannot be issued with only an Improvement Permitp
PROPERTY LOCATION:
ISSUED TO: SUBDIVISION C cys-c~ C a~ ~~ecit~.Sf' LOT # 3~
NEW e' REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: W
Proposed Wastewater System Type: a57;E, 1,4-
Projected Daily Flow VC GPD
Number of bedrooms: s~ Number of Occupants: max
Basement ❑Yes ado ~
Pump Required: ❑Yes El No I? "May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community e Public ❑ Well Distance from well feet Permit valid for ve years
Permit conditions: ❑ No expiration
Authorized State Agent. ,.~e Date: ~7 /02- /k- f a SEE ATTACHED SITE SKETCH
The issuance of this permit b 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 TO: G.t PROPERTY LOC ON: c~ aJ q
SUBDIVISION rsi,' s g
~J1,-,r LOT #
Facility Type: 2 New ❑ Expansion ❑ Repair
Basement? ❑ Yes ❑ No Basement Fixtures? / ❑ Yes ❑ No
Type of Wastewater System**~ (Initial) Wastewater Flow: ti GPD
(See note below, if applicable
~/.4c,,._ (Repair)
Installation Requirements/Conditions Number of trenches
Septic Tank Size 2_ 5_0
gallons Exact length of each trench J-0 feet
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of I6~ inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
Pump Requirements: ft. TDH vs. GPM
Trench Spacing: 99 Feet on Center
Soil Cover. L /7 inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
. Aggregate Depth:
r Q✓r c~ f
inches below pipe
inches above pipe
inches total
**If applicable: /understand the system type specified is different from the type specified on the app/ication. / accept the specifications of this permit.
Owner/legal Representative Signature: Date:
M, r. ...A_
vm na p-r, play ur we filtriWCU use changes. ine construaion aumortzation snan not be transterred when there is a change in ownership of the site. This
tonstructron authorization is subject to co nce with the provisions of the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit. SEE ATTACHED SITE SKETCH
~tl_ -
Authorized State Age Date: "2X C/ C
Construction Authorization Expiration Date: ~2C arm
HTE# /d = a5~ LF), Permit # Q.~ 1 C•
Hl"r'nett Cot"ItY Department of Public Health
Site S ketch
PROPERTY LOCATON: 't Szrclb. ~1_
ISSUED TO: SUBDIVISION LOT # J"Q
Authorized State Agent- Date:
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Department of Environment, Health and Natural Resources Sheet:
Division of Environmental Health Property ID;
On-Site Wastewater Section Lot Property
SOIIJSJTZ EVALUATION File M:
for ON-S1TB WASTEWATZR SYSTEM Code:
Owner: Applicant:
Addn= Date Evah>ated:
Proposed Facility DCdP FLOW (.1949p. Property Size:
Locadon of Site: Pro" hcorded:
Water suppijr ; 1#c ❑ Individual ❑ Well C1 Spring ❑ other
Evaluation Method: Auger Boring ❑ Pit Cu
Type of Wastewater: Sewage ❑ Industrial Prmu Mixed'.
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utaer Fedora (.1946)
Site Ciasd&adou (.1948)
Evehated By:
Others Ph-m*