IPAC RHTE# - � JZ Harnett County Department of Public Health
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: IzAn
ISSUED T0: SUBDIVISION LOT #
NEW E] REPAIR 54 EXPANSION Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: fr-a
Proposed Wastewater System Type:
Projected Daily Flow: -2-, GPD
Number of bedrooms: :- Number of Occupants: max
Basement ❑Yes NNoo ..--
Pump Required: ❑Yes L`N0 ❑ May be required b on final location and elevations of facilities
Type of Water Supply: F-1 Community 1:1 Public L Well Distance from well et
Permit conditions:
Permit valid for:
2-five years
❑ No expiration
Authorized State nt:: r Date: t l — lb —/y SEE ATTACHED SITE SKETCH
The issuance of this permit by a ealth 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 a 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 T0: PROPERTY LOCATION: % "
1 SUBDIVISION LOT #
Facility Type: + ❑ New El -Expansion LT" Repair
Basement? 11 Yes No Basement Fixtures? F-1 Yes a.No
Type of Wastewater System ** g' (Initial) Wastewater Flow: P GPD
(See note below, if applicable ❑)
O' S (Repair)
Installation Requirements/ Conditions Number of tren hes
Septic Tank Size " all Exact length of each trench - feet Trench Spacing:' Feet on Center
Pump Tank Size gallons Trenches shall be installed on contour at a Soil Cover: """ inches
It
Pump Requirements: ft. TDH vs.
Conditions:
Maximum Trench Depth of: inches
(Trench bottoms shall be level to +/ -1/4"
in all directions)
GPM
°i
(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 LOFT. 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 specifed on the app /ication. / accept the specifications of this permit.
Owner /Legal Representative Signature: Date:
This 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 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 A t: Date:
Construction Authorization Expiration Date:
HTE# % - Permit # ~
Harnett County Department of Pablic Health
Site Sketch
PROPERTY LOCATON:.- /— Y /1' 4,,gj"
ISSUED TO: 1--� Aj u SUBDIVISION LOT #
Authorized State Agenj �� �f1 r� Date:
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HARNETT COUNTY, NORTH CAROLINA
GISIEAND RECORDS
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