IPAC RHTE# 94 --5- 345 2, Harnett County Department of Public Health 28043
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: 1 ") Cod �L2 1 W E�—T
ISSUED T0: a t --l' E� > y Fri P C _ SUBDIVISION LOT #
NEW ❑ REPAIR ❑ EXPANSION °A , Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: ��a —�—oS> ��p �-1a,z,t tea
Proposed Wastewater System Type: °%o »G> % GY'
Projected Daily Flow: 35 1 GPD
Number of bedrooms: Number of Occupants: 1 1--7 max
Basement ❑Yes ANo
Pump Required: ❑Yes -.No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community Public El Well Distance from well `� feet Permit valid for
Permit conditions: �B %> �Gl�l t s i Q VA c.> t —�'�`)
c
Five years
❑ No expiration
Authorized State Agent:: Date: 10 SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the i�ssuaoce'��r permits. The permit holder is respo ible 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.
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: 0 i .� �C- L1 �t C-sz� V'A' t,S✓ PROPERTY LOCATION:
SUBDIVISION
Facility Type: ��-� �,r, 5 t L o P \ l��-t- El New X Expansion ❑ Repair
Basement? ❑ Yes 'N� No Basement Fixtures? ❑ Yes '�( No
Type of Wastewater System ** r�5°� o P-C�sov G'�e 0-r-- (Initial) Wastewater Flow:
(See note below, if applicable ❑)
G1 6 Q-G- uc c`toct Sy77Gn, (Repair)
Installation Requirements /Conditions Number of trenches
Septic Tank Size gallons Exact length of each trench CoS feet
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of: IS inches
(Trench bottoms shall be level to +/ -1/4"
in all directions)
Pump Requirements: ft. TDH vs. GPM
Conditions:
LOT #
2�5 1 GPD
Trench Spacing: Feet on Center
Soil Cover: inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
inches below pipe
Aggregate Depth: inches above pipe
inches total
WATER LINES (INCLUDING IRRIGATION) MUST BE ]OFT. 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 specifled is different from the type specified on the application. / accept the specifications of this permit.
Owner /Legal Representative Signature: Date:
This Construction Authorization is subject to do 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" to complianc`�Lthe the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent: VJZN Date: f
Conitqction Authorization Expiration Date: —
Permit # d' ?-,OL 3
Department Harnett County •
Site Sketch
PROPERTY LOCATON:
ISSUED TO: �-Ao GE SUBDIVISION LOT #
Authorized State Agent:
lily