IPAC RHTE # -s -3a�v z Harnett County Department of Public Health 28110
Improvement Permit
A building permit cannot be issued with only an � Improvement Permit
/
PROPERTY LOCATION: `w( —/'e— / W; Worm
ISSUED TO: C SUBDIVISION LOT #
NEW 2' REPAIR ❑ EXPANSION ❑
Type of Structure: 5FD g6 tC 6 y
Proposed Wastewater System Type: �y dus1:._,n �. rbe"
Projected Daily Flow: //150 GPD
Number of bedrooms: ly Number of Occupants: _max
Basement ❑Yes 1210
Site Improvements required prior to Construction Authorization Issuance:
Pump Required: ❑Yes ERIN o El be required based on final location and elevations of facilities
Ma
Type of Water Supply: ❑ Community Public ❑ Well Distance from well feet
Permit conditions:
Permit valid for:
E�rFive years
❑ No expiration
Authorized State Agent:: / %_ �LS: �>,e �. �C Date: yG /a �/Z °/`/ SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees 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 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: C„nM =nS/ PROPERTY LOCATION: I ul -re-1 "�Jbn
SUBDIVISION LOT #
Facility Type: SF D 9 X c. New ❑ Expansion ❑ Repair
Basement? ❑ Yes C7'No Basement Fixtures? ❑ Yes ❑ No
Type of Wastewater System ** �S�% ,Qe �uc�: vh S fM (Initial) Wastewater Flow:
(See note below, if applicable ❑)
(Repair)
Installation Requirements /Conditions Number of trenches IV
Septic Tank Size /000 gallons
Pump Tank Size gallons
Pump Requirements: ft. TDH vs.
Exact length of each trench /00 feet
Trenches shall be installed on contour at a
Maximum Trench Depth of: /8 -Xq inches
(Trench bottoms shall be level to +/ -1/4"
in all directions)
GPM
-/60 GPD
Trench Spacing: Feet on Center
Soil Cover: U -lZ inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
r r Aggregate Depth:
ns: �c� t� C) -11, br ufeJ c n . 4,, /<--c, Ad"tl: :..7`•
( G,-,— i--- —, _ sir c
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.
inches below pipe
inches above pipe
inches total
* *If applicable: /understand the system type specified is different from the type specified on the application. / accept the specifications of this permit.
Owner /Legal Representative Signature: Date:
Thic rnnctrnrtinn dnthnrivatinn it mhierf to revnratinn if the tite nlan_ nlat nr 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 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 Agent: k� t L ;_ .' X Date: /0 (aV1.2 G
t
Construction Authorization Expiration Date: o ,;,, / a i
HTE# /q-,5 -- ,3.E-7a12 Permit
Harnett Connty Department of 1-kiblic Health
Site Sketch
PROPERTY LOCATON: Isu I-M l �s x 6A
ISSUED TO: �✓��U �M -n SUBDIVISION LOT #
Authorized State Agent: /�'� -c ,E'� /7 Date: �d17 -64Q�Z