IPAC RHTE# 1Lt -,3���� Har,_.ct County Department of Public .,ealth 28012
Improvement Permit
A building permit cannot be issued with only an Improvement Permit 7
-09 r ,<t PROPERTY LOCATION: I—C-e C4 v T, % L) , e (u g�
ISSUED TO: Q-P Q.,e�L c�z�°2F�tG�= Nq,'*%P. SUBDIVISION LOT # t�
NEW REPAIR ❑ EXPANSION ❑
Type of Structure: r l .a 0 M
Proposed Wastewater System Type: /r, 'J c::, 10 N
Projected Daily Flow: GPD
Number of bedrooms: Number of Occupants: �' max
Basement ❑Yes > No
Site Improvements required prior to Construction Authorization Issuance:
Pump Required: ❑Yes "_'JmIdo ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community >�[' Public ❑ Well Distance from well l feet Permit valid for Five years
Permit conditions _6 ❑ No expiration
Authorized State Agent:: �. ~e �!, �I- Date: ' �` � SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the issuai mils. The permit holde 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 Improveme t 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: CNg�GL'G L-- C � � - °�r1.�S S P\ PROPERTY LOCATION: C-0U
SUBDIVISION �' LOT # Ll
Facility Type: Amt �%mE�i 2''� ®� � New ❑ Expansion ❑ Repair
Basement? ❑ Yes 'X No Basement Fixtures? ❑ Yes o
a
Type of Wastewater System ** �-� 1® AL'S r b.N (Initial) Wastewater Flow: 2Q0 GPD
(See note below, if applicable ❑)
2.57 uG'Si p N �% —,6r(l (Repair)
Installation Requirements/Conditions Number of trenches
Septic Tank Size l0':::) gallons Exact length of each trench C,® feet
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of.- 1 inches
(Trench bottoms shall be level to +/ -1/4"
in all directions)
Pump Requirements: ft. TDH vs. GPM
Conditions:
Trench Spacing: i Feet on Center
Soil Cover: —ice inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
inches below pipe
Aggregate Depth: inches above pipe
inches total
WATER LINES (INELUDING IRRIGATION) MUST BE IOFT. FROM ANY PART OF SEPTIC SYSTEM OR REPAIR AREA.
NO UTILITIES ALLOWED IN INITIAL OR REPAIR DRAIN FIELD AREA.
* *If applicable: l understand the system type specifed is different from the type specified on the app lication. / acrept the specipcations of this permit.
Owner /Legal Representative Signature: Date:
This Construction Authorization ' subject to re tte p lak 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 i bj ", pliance wrt e and R ules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent:
Expiration Date:
a
Permit # a",,) i42,
Department of 1--)ttblic Healtl
Site Sketch
PROPERTY LOCATON: LE-G C7VN-5�) L)Nc--Q=D
SUBDIVISION LOT #
—7) -h
Authorized State Agent: Qla�S 6--Nel— Date: I
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L C- a Coy -j"5`1 Li CZP
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Aug ']U "14 "I U:Lba
From:
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07131/2014 09:47 #170 P.0021'006
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Harnett C,unty Department of Public Health
Site Sketch
PROPERTY 1DCATDN: �..�C. Ce7v nrj �-- "�G
!� �s'C{�. SUBDIVISION LOT #�
ISSUED TU: `t
�5 Li Date:
pathoized State Agent
135
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