IPAC RHTE# \-A Harnett County Department of Public Health 28039
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: } }3 �. N o s2.cro a CJ W ISSUED TO: V4 E�� mtn�� C SUBDIVISION LOT #
NEW ❑ REPAIR ❑ EXPANSION
Type of Structure: 5.�* �5-
Proposed Wastewater System Ty e: s--, o .5' 0( t o�
Projected Daily Flow: ��� GPD
Number of bedrooms: 1'1 Number of Occupants: max
Basement ❑Yes -" <No
Site Improvements required prior to Construction Authorization Issuance:
Pump Required: ❑Yes ",�oo ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community Public ❑ Well Distance from well Lb 0 feet Permit valid for. Five years
Permit conditions - - ❑ No expiration
Authorized State Agent:: Date: `c It Z3i-) L-� SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the issuai f other permits. The permit holder i responslble 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 Improvem t.,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, .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: V -EN CV 1,10M PROPERTY LOCATION: ®!?� CN cn-� ►� �� G CZ-p
SUBDIVISION LOT #
Facility Type: "FP ❑ New Expansion ❑ Repair
Basement? ❑ Yes '15Z No Basement Fixtures? El Yes -I o
Type of Wastewater System ** 2-� °l a w CS s.1 (Initial) Wastewater Flow: GPD
(See note below, if applicable ❑) � �
� s�Z o �F --G:D V CA (Repair)
Installation Requirements /Conditions Number of trenches
Septic Tank Size gallons Exact length of each trench DS feet Trench Spacing: i Feet on Center
Pump Tank Size gallons Trenches shall be installed on contour at a Soil Cover: G ° 1 2 inches
Maximum Trench Depth of: t't -'.L'� 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 specified is different from the type specified on the application. / accept the specilcations of this permit.
Owner /Legal Repirmntative Signature: Date:
This Construction Authorizati n is subl ocation if the an, 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 i o comp" with ovisions a Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent: yy�� Date:
Con ruction Authorization Expiration Date: _
HTE# Permit # a'bO?>C\
Authorized State Agent:
N
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L)-q —% OL-,fSOfO -0 Date: L.,
Name: (owner) � New Installation Se tic Tank
1.
Property Location: SE.# � J -� D P1.�t -r. �� ■ Repairs Nitrification Line
Subdivision Iy A Lot #
TAX ID# Quadrant #
Contractor. L— 5 V(- Registration #
Basement with Plumbing: ❑ Garage:
Water Supply: ❑ Well �Public ❑ Community
Distance From Well: 5Z), ft.
Following are the specifications for the sewage disposal system on above captioned property.
Type of system: Conventional ❑ Other
Size of tank: Septic Tank: ej° ° gallons Pump Tank: gallons
Subsurface No. of exact length �b aitdches f_ ft. ditches f 1� a in.
Drainage Field ditches of each ditch
French Drain: Linear feet
PERNIIT NO.
Date: 5- r3-14
Inspected by:: L'J
Environmental Health Specialist
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