IPACHTE# V-` 3ta5C� Harnett County Department of Public Health 28195
Improvement Permit
Authorized State Agent:: Date: -3 ) 's-1 1: j— SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees ssu of other permits. The permit holderfis e 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 Ruent 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:
A building permit cannot be issued with only an Improveme t Permit
LOT #
Basement? ❑ Yes ❑ No Basement Fixtures? ❑ Yes ❑ No
c,' PROPERTY LOCATION:
Type of Wastewater System" a_'/a t'U cz�
ISSUED TO: oso K Os—
L SUBDIVISION
LOT #
NEW ❑
REPAIR ❑
EXPANSION Site Improvements required prior to Construction Authorization Issuance:
Type of Structure:
Q c.,i-': , �)
-, • _r ,CZ
Pump Tank Size gallons Trenches shall be installed on contour at a
Proposed Wastewater System Type:
®/6 ovcG t a N
(Maximum soil cover shall not exceed
Projected Daily Flow:
36" above the trench bottom)
GPD
Number of bedrooms:
inches below pipe
Number of Occupants: max
Basement ❑Yes
XNo
Pump Required: ❑Yes
No
❑ May be required based on final location and elevations of facilities
Type of Water Supply:
❑ Community
Public ❑ Well Distance from well VB Q feet
Permit valid for: Five years
Permit conditions:
_
❑ No expiration
Authorized State Agent:: Date: -3 ) 's-1 1: j— SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees ssu of other permits. The permit holderfis e 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 Ruent 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:
SUBDIVISION
facility Type: QL NS1s 1:1 New Expansion ❑ Repair
LOT #
Basement? ❑ Yes ❑ No Basement Fixtures? ❑ Yes ❑ No
Type of Wastewater System" a_'/a t'U cz�
(Initial) Wastewater Flow: IM GPD
(See note below, if applicable ❑)
Pucno �a uL-C�ti�l (Repair)
Installation Requirements/Conditions Number of trenches
Septic Tank Size_ , y L gallons Exact length of each trench 11-1 0 feet
Trench Spacing: I Feet on Center
Pump Tank Size gallons Trenches shall be installed on contour at a
Soil Cover: 4; inches
Maximum Trench Depth of: 1`2, 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: fc, 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: /understand the system type spedped is different from the type speciped on the app/ication. /accept the specifcatians of this permit.
Owner/Legal Representative Signature: Date:
This Construction Authorization is subject to revobtiq 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 ism compliance the p ''o f the laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent: Q -1A5 Date: 3 '
Const ' n Authorization Expiration Date:a
HTE # � -A-S'3 LJ5 QPermit # a � ) 0S
Harnett County Department of Public Health
Site Sketch
PROPERTY LOCATON:
ISSUED TO: SUBDIVISION LOT #
L -\N C�Z —Vo
Authorized State Agent: Date: 3
is
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