IPAC RType of Structure:
Proposed Wastewater System Type:
Projected Daily Flow: Li IR PD
Number of bedrooms: Number of Occupants: max
Basement ❑Yes No
Pump Required: es ❑ No ❑ May e required based on final location and elevations of facilities
Type of Water Supply: El Community L Public ❑ Well Distance from well feet Permit valid for: D-rive years
Permit conditions: ❑ No expiration
Authorized State eee,,,Ilh F % yam! Date: to ° i — /LI' SEE ATTACHED SITE SKETCH
The issuance of this permit Department in no wayway gT the 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 n, 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, .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: !;16 PROPERTY LOCATION: 5 G " 4
SUBDIVISION LOT #
Facility Type: rm' New ❑ Expansion ❑ Repair
Basement? ❑ Yes No, Basement Fixtures? ❑ Yes
,z
,Expansion
of Wastewater System ** s (Initial) Wastewater Flow: GPD
(See note below, if applicable ❑)
L- epalr
Installation Requirements /Conditions Number of trenches z
Septic Tank Size gallons Exact length of each trench 60 feet Trench Spacing: Feet on Center
Pump Tank Size gallons Trenches shall be installed on contour at a Soil Cover: inches
Maximum Trench Depth of: a-18 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
Aggregate Depth:
Conditions:
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
2 inches above pipe
Z— inches total
* *If applicable: / understand the system type specified is different from the type specified on the app /ication. / accept the specifications ofthis permit.
Owner /Legal Representative Signature: Date:
This Construction Authorization is subject to revocation if the site plan, plat, or the intended use chances. The Construction Authorization shall not be transferred when there is a change in ownership 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 Date: ro — -7 — r N
,t5�� Construction Authorization Expiration Date: /v —7 —/.
HTE# /q °5 '` 5�� Permit #
Harnett Connty Department of iblic Health
Site Sketch
ISSUED T0: <J D<
Authorized State
Date: /0— 7 ` /
�., t ,
300