IPAC RATE#114 - 5-,315 J a3,9, Hak At County Department of PubliL Jealth 2 8
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Imarovement Permit
A building permit cannot be issued with only an Improvement Permit
(� PROPERTY LOCATION: h� rtOGPas L- N
ISSUED TO: t` o S�FcL o -GC— -S5 1A t SUBDIVISION LOT #
NEW REPAIR ❑ EX SIO ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure:
Proposed Wastewater System Type: q C.r-
Projected Daily Flow: `3 r -n® GPD
Number of bedrooms: 2> Number of Occupants: max
Basement ❑Yes >ik No
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 10Q feet Permit valid for: Five years
Permit conditions: --- ❑ No expiration
Authorized State Agent:: `\ 5 Date: 11 30t 1 S SEE ATTACHED SITE SKETCH
I
The issuance of this permit by the Health Department in now t e rantees issua other permits. The permit holder is respod�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 us c Improvemei 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 an Disposal an tions
ss
C2�v,3%3,1 tS
Reauired for Building Permit
The construction and installation requirements of Rules .1950, .1952, .1954, .1955, .1956, .1957, .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 t
ISSUED T0: eg �cGtrs _ PROPERTY LOCATION: vW floc. Lo
��� , � SUBDIVISION LOT #
Facility Type: New ❑ Expansion ❑ Repair
Basement? ❑ Yes No Basement Fixtures? ❑ Yes AND
Type of Wastewater System** 9Z 6jo u 1 (:-:5 � Ci .ry SYS F rn (Initial) Wastewater Flow: K 0 GPD
(See note below, if applicable ❑)
�—� (D/G �.E Z) vc,!�' 1 G (Repair)
Installation Requirements/Conditions Number of trenches 3
Septic Tank Size I ®Od gallons Exact length of each trench 1®® feet Trench Spacing: Feet on Center
Pump Tank Size gallons Trenches shall be installed on contour at a Soil Cover: Q inches
Maximum Trench Depth of: W -3,L-5 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: 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 specified is different from the type speciFed on the application. / accept the specifications of this permit.
Owner/Legal Representative Signature: Date:
This Construction Authorization is su I re ocati '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 scompliance `"ons of the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agerti�—
Date: Q3
on Authorization Expiration Date: t
HTE# 351i),IQ, Permit # `off. )�fl
Harnett County Department of 1-`�ablic Health
Site Sketch
'�} PROPERTY LOCATON: W 4 L-oC)�Ltf
ISSUED T0: SUBDIVISION LOT #
Authorized State Agent:
,4.,kG.4,ss� �G2 Nc�, 1—iovsE
M
Date: 1 qp 5