IPAC RHTE# C 9- 5 -IG33% P, Harnea County Department Public ticalth 24543
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
V.I Quo PROPERTY LOCATION: ,mo,_ GarJ.r�
ISSUED TO: �i'�s-rs�- SUBDIVISION C..-1 W coos. LOT #
NEW` REPAIR ❑ EXP.ANSiON 1-1 Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: S"P 4> Q-13' �S'
Proposed Wastewater System Type: Co N.r sAn ,a,aPL.
Projected Daily Flow: 44b GPD
Number of bedrooms: 4 Number of Occupants: `� max
Basement ❑Yes '9 No
Pump Required: ❑Yes ❑ No 4 May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community K Public ❑ Well Distance from well I OO feet Permit valid for:
Permit conditions:
Five years
❑ No expiration
Authorized State Agent:: 7�� e=' Date: 3JL IN SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarante issuance of other permits. The permit holder 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 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.
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. M a'c6 - rxic><� 6+
ISSUED TO: '�o Qvg PROPERTY LOCATION: �A 9-D
SUBDIVISION CryP \0 nans LOT #
Facility Type: SF D L-73->030 A New ❑ Expansion ❑ Repair
Basement? ❑ Yes \9 No Basement Fixtures? ❑ Yes No
Type of Wastewater System ** C.-o N (Initial) Wastewater Flow: 4170 GPD
(See note below, if applicable ❑)
"Q -P (Repair)
Instaflation Requirements/Conditions
Septic Tank Size loop gallons Exact length of each trench 120 feet Trench Spacing: Feet on Center
Pump Tank Size gallons Trenches shall be installed on contour at a Soil Cover. C, inches
Maximum Trench Depth of. t9 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: �L,_ Y" on— la \Ov,; boa— ' i,VAL_ Syss'b�.� ,�A ots� 1�, inches total
* *If applicable: I understand the system type specified is different from the type specIfled on the app /ication. / accept the specifications of this permit.
Owner /Legal Representative Signature: Date:
[his Construction Authorization is subject to 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 Authorizatio 's su 'ect t 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 Agent: Date:���
Construction Authorization Expiration Date: t3
Permit # '-�,4 5 Lj 3
Harnett County Depailinent of IlUblic Health
Site Sketch
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