IPAC RHTE# � Harie..ct County Department of Public .,ealth
Improvement Permit 27401
A building permit cannot be issued with only an Improvement Permit
S�sYY`% PROPERTY LOCATION:
ISSUED TO: �a m�5 LL C-- SUBDIVISION K LOT # G9
N EWT1, REPAIR ❑ IPANSION [I Site Improvements required prior to Construction Authorization Issuance:
Type of Structure:
Proposed Wastewater System Type: U0;
Projected Daily Flow: 4 -- GPD
Number of bedrooms: 4
Basement ❑Yes ->� No
Pump Required.)Kes ❑ No
Type of Water Supply: ❑ Community
Permit conditions: —
Authorized State Agent::
The issuance of this permit it
site is subject to revocation it
the Laws and Rue ap
Number of Occupants: '2 max
❑ May be required based on final location and elevations of facilities
Public ❑ Well Distance from well lQ O feet Permit valid for:( Five years
❑ No expiration
t in no way guarantees the issuance bfve
the intended use changes. The Improvement
and to conditions of this per it
`5 Date: 311 Si !� SEE ATTACHED SITE SKETCH
permits. The permit holiter is r ponsible for checking with appropriate governing bodies in meeting their requirements. This
"eti nit shall not be affected by a change in ownership of the site. This permit is subject to compliance with the provisions of
Construction Authorization
(Required for Building Permit)
The construction and installation requirements of Rules .1950, .1952, .1954, .1955, .1956, .1951, .1956. 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: S M" "C) cn�-.5 I-°L -r- PROPERTY LOCATION: , rzL RD
U SUBDIVISION sv1 -�>� e ms LOT #
Facility Type: "�t's� New ❑ Expansion ❑ Repair
Basement? ❑ Yes No Basement Fixtures? ❑ Yes X No
Type of Wastewater System ** Q'Ia °c% 9- -C=n�') CJ-V 10M S --�5 7G n
U 0 P (Initial) Wastewater Flow: WO GPD
(See note below, if applicable ❑
v WV d A-S °10 �1EnUC, 10 N (Repair)
Installation Requirements /Conditions Number of trenches
Septic Tank Size i ®Q gallons Exact length of each trench -7 5 feet Trench Spacing: Feet on Center
Pump Tank Size > 10 0 gallons Trenches shall be installed on contour at a Soil (over: G'I')- inches
Maximum Trench Depth of: )`06 ' 3�-k 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: S v P ezy LN N 1 c, Sim C rv; � �"U-y inches total
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.
* *If applicable: / understand the system type specified is different from the type specified on the app lication. / accept the specifications of this permit.
Owner /Legal Representative Signature: Date:
This Construction Authorization o revocation if the site plan, 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 subect to compliance s of the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Au ed Slat y\5 Date: S ' !;- 13
,01 �� o truction Authorization Expiration Date:
�S
HTE # 0— Permit # 1-1 -qc I
H(arnett County Department of Public Health
Site slietell
ISSUED TO:
Authorized State Agent:
M
U M -, qp,
C2-1