IP-OnlyHTE#
Harnett County Department of Public Health
Irn~rovement Permit 2 6 2 0 9
A building permit cannot be issued with only an Improvement Permit
ISSUED T0: `)rt PROPERTY LOCATION: 1 W`y~n r.~
SUBDIVISION 1 % N Gt~r.S ~10 H~ E LOT # 10C
NEW X REPAIR ❑ EXPANSION ❑ Site Improvements required rior to C truction Authorization Issuance:
Type of Structure: (60 n6~~
Proposed Wastewater System Type: Ov mp 0 2.5°~ R~vL o ~p
~
Projected Daily Flow: 3(. O GPD
Q5 Q09
osfl.~ P QP,~N ~rrul Q
Number of bedrooms: ' Number of Occupants: max
Basement ❑Yes No 1;P20 M L..:L-
Pump Requirecl.>~Yes ❑ No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community Public ❑ Well Distance from well 0 Q
Permit conditions: feet Permit valid for. )5~ five years
❑ No expiration
Authorized State Agent:
Date: -7 2•\ \0 SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the issuanc other permits. The permit hol r is re onsible 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 .195o, .1952, 1954, .1955, .1956, .1957, A% 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
❑ New
Basement fixtures? ❑ Yes
PROPERTY LOCATION:
SUBDIVISION
❑ Expansion ❑ Repair
❑ No
Installation Requirements/Conditions;
(Repair)
Number of trenches
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 +1-114"
Pump Requirements: ft. TDH vs.
in all directions)
GPM
Conditions:
LOT #
(Initial) Wastewater flow: GPD
Trench Spacing: Feet on Center
Soil Cover. inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
inches below pipe
Aggregate Depth: inches above pipe
inches total
WATER LINES (INCLUDING IRRIGATION) MUST BE ]OFT. FROM ANY PART OF SEPTIC SYSTEM OR REPAIR AREA.
NO UTILITIES ALLOWED IN INITIAL OR REPAIR DRAIN FIELD AREA.
**If applicable: / undefftand the system type specified is different from the type specified on the application. / accept the specillcations of thin permit.
Owner/Legal Representative Sjgnature:
This Construction Authorzation is subject to revocatplan, plat or the intended use changes. The Constructor Authorization shall not be traen Dae is a change in ownership of the SIT;E~TCH
Thist action Authorization
Thi is subject to compliance visions of the Laws and Rules for Sewage Treatment and Disposal and to the conditions t SEE ATTACHED Authorized State Agent:
Date: _
Construction Authorization Expiration Date: