IP-OnlyHTE# ~a s~a~-►-~~ Harnett County Department of Public Health
Improvement Permit 2 6 21 0
A building permit cannot be issued with only an Improvement Permit
r PROPERTY LOCATION: T-lw-t \'4
ISSUED TO: yc+eJ SUBDIVISION '5 NGI>sJ 0"1 4 L LOT # t05
NEW REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: S Ffl ( ~Aty Oc1D ~sd ~Sn E1'. A~ \Np~ c \-~F
Proposed Wastewater System Type: Qur-?-7o a5°o REjZ)k. ~1pt-A
Projected Daily Flow: 3(00 GPD d a PaoP~`~L-.tvL Qpr ~~~H 1
Number of bedrooms: Number of Occupants: JZ max
Basement ❑Yes >qo
Pump Required kes ❑ No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community 9 Public ❑ Well Distance from well \-O feet Permit valid for. Five years
Permit conditions:
❑ No expiration
Authorized State Agent:: t~-3 Date: Z` SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the issuance of o ermits. The permit holder is sponsible 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, .1957, .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:
Facility Type:
Basement? ❑ Yes ❑ No
Type of Wastewater System** _
(See note below, If applicable
PROPERTY LOCATION:
SUBDIVISION
❑ New ❑ Expansion ❑
Basement Fixtures? ❑ Yes ❑ No
Repair
LOT #
(Initial) Wastewater Flow: GPD
Installation Requirements/Conditions
Number of trenches (Repair)
Septic Tank Size gallons
Exact length of each trench 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 inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
Aggregate Depth:
WATER LINES (INCLUDING IRRIGATION) MUST BE LOFT. FROM ANY PART OF SEPTIC SYSTEM OR REPAIR AREA.
NO UTILITIES ALLOWED IN INITIAL OR REPAIR DRAIN FIELD AREA.
inches below pipe
inches above pipe
inches total
**If applicable: l understand the ryrtem type .rpecided it different from the type rpecifled on the application. l accept the rpecificationJ of thi 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:
Date: _
Construction Authorization Expiration Date: