IPACHTE #11-4r °5-35j10 Harnett County Department of Public Health 2794
Improvement Permit
A building permit cannot be issued with only an Improvement Pe tt
M PROPERTY LOCATION: CS— Low tv
ISSUED T0: -i rAs %>i tr'�) , SUBDIVISION "` LOT #
NEW X REPAIR ❑ NSION ❑
Type of Structure: 5G9
Proposed Wastewater System Type: r-�-S®f r1
Projected Daily Flow: 3� GPD rr
Number of bedrooms: Number of Occupants: b max
Basement ❑Yes No
Site Improvements required prior to Construction Authorization Issuance:
Pump Required: ❑Yes ❑ No EfMay be required based on final location and elevations of facilities
Type of Water Supply: ❑Community Public ❑ Well Distance from well l0 feet Permit valid for: XFive years
Permit conditions: ❑ No expiration
Authorized State Agent:: Date: Q:� , a SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the issuance ther permits. The permit holder is re ponsible 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 Improvemen rmit 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, .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 T0: rr co ram PROPERTY LOCATION:
SUBDIVISION LOT #
Facility Type: New ❑ Expansion ❑ Repair
Basement? ❑ Yes No Basement F' tures? ❑ Yes o
Type of Wastewater System ** `a5 ®�® y C �\ C) N y 5 s — (Initial) Wastewater Flow: 2Q� GPD
(See note below, if applicable ❑)
?U c�}Q o S �o A�vG�1 C)�1 (Repair)
Installation Requirements /Conditions Number of trenches `Z-
Septic Tank Size \.® c> O gallons Exact length of each trench ® feet Trench Spacing: Qi Feet on Center
Pump Tank Size gallons Trenches shall be installed on contour at a Soil Cover: 11— inches
Maximum Trench Depth of- 20 _ A 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: inches total
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.
* *If applicable: / understand the system type speciled is different from the type speciled on the application. / accept the specilcations of this permit.
Owner /Legal Represent nature: Date:
This Construction Authorization is subject to revoa ' the s n, 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 subjecKompliance wi a pro w Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent:
Date: C
Authorization Expiration Date: ' C
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