IPAC RHTE# I!a I ?Y-e0 / 1Z Harnett County Department of Public Health
28057
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: 1615'3 Z Jam_ 9,C� C1,1
ISSUED SUBDIVISION LOT #
NEW 5 REPAIR ❑ EXPANSION Site Improvements required prior to Construction Authorization Issuance:
Type of Structure:
Proposed Wastewater System Type: ZSz3'a
Projected Daily Flow: tea° GPD
Number of bedrooms: 3 Number of Occupants: G max
Basement []Yes ®No
Pump Required: ❑Yes ❑ No 21a be required ba d on final location and elevations of facilities �/
Type of Water Supply: ❑ Community Public LJ' Well Distance from well /� feet Permit valid for: P hive years
Permit conditions: ❑ No expiration
Authorized State Aon d Date: IV— I--Ii SEE ATTACHED SITE SKETCH
The issuance of this permit the alth Department in no way guarantees the issuance of o ier permits. The permit holder is responsible for checking with appropriate governing bodies in meeting their requirements. This
site is subject to revocation a 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, .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: /�Ca/�✓ -� z h i PROPERTY LOCATION:,-5C..'53'7- , --#-
'-' SUBDIVISION LOT #
Facility Type: Z New F-1 Expansion El Repair
Basement? ❑ Yes No Basement Fixtures? ❑ Yes CNo
Type of Wastewater System ** 796/v &670Z- F -2s10 (Initial) Wastewater Flow: -5 GPD
(See note below, if applicable ❑)
M
Z.o',, (Repair)
Installation Requirements /Conditions
Number of tr ches 2-
Septic Tank Size 000 gallons
Exact length of each trench ,/20 feet
Pump Tank Size gallons
Trenches shall be installed on contour at a
Maximum Trench Depth of: 49, �/g 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 IOFT. 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: /understand the system type rpeciled is different from the type speciled on the application. / accept the specilcations of this permit.
Owner /Legal Representative Signature: Date:
This Construction Authorization is subiect to revocation if the site Dian, plat, or the intended use changes. The Construction Authorization shall not be transferred when there is a change in ownershin 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 A Date: 9- S /N
Construction Authorization Expiration Date: 9
HTE# Permit # 28,057
Harnett County Department of Public Health
Site Sketch
— PROPERTY LOCATW;ft, 1 �2 0 Y Gar uvc Lit 26
ISSUED TO: je,&J—X� " SUBDIVISION LOT
Authorized State Agwc�)�� Z A6� Date: y
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