IPAC RRNTE# /,V-3`-,3 cl.�6 /?- Harnett County Department of Public Health 28289
Improvement Permit
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AId6,ermit cannot be issued with only an Improvement Permit
fe, 4-cuPROPERTY LOCATION: 3-o k._%fV C�
ISSUED —TO- �o,V, �" I C -0X SUBDIVISION LOT #
NEW REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: k � y �' " 'c 3l� lC 7 (a
Proposed Wastewater System Type: & nne ko
Projected Daily Flow: 6-70 GPD '.5-0 kr � s
Number of bedrooms: Number of Occupants: E) `-'`Y' ky`max
Basement ❑Yes VIN —
Pump Required: ETes ❑ No ❑Ma be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community Public ❑ Well Distance from well feet Permit valid for: E five years
Permit conditions: ❑ No expiration
Authorized State Agent::l��r,.� � wy:.,... eq/ Date: �`f f /2 0/r' 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 c fC PROPERTY LOCATION:
3-0 .ed
SUBDIVISION
LOT #
Facility Type: -N>y CIO--(- T New ❑ Expansion ❑ Repair
Basement? ❑ Yes b No Basement Fixtures? ❑ Yes ❑ No
Type of Wastewater System**
(Initial) Wastewater Flow: 870 GPD
(See note below, if applicable ❑)
tiJ- (Repair)
Installation Requirements/Conditions Number of trenches
Septic Tank Size ')'pO0 gallons Exact length of each trench %0 feet
Trench Spacing: �_ Feet on Center
Pump Tank Size oZ _00 0 gallons Trenches shall be installed on contour at a
Soil Cover: inches
G-,r-e4r,e-7-vr4 /000 yz ►t-- Maximum Trench Depth of: /8-313 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
r
Conditions: J -'e a - c I-, t. -�Q Ucs-r , *�r ,�_
Aggregate Depth: a2 inches above pipe
(� `,,��t / Z inches total
A- t Cis e v �- EK/?"e .� .
WATER LINES (INCLUDING IRRIGATION) MUST BE IOFT. 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 specired is different from the type specified ofl the application. / 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 chances. The Construction Authorization shall not be transferred when there is a change in ownershin of the site. This
Construction Authorization is subject to
Authorized State
with the provisions of the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit. SEE ATTACHED SITE SKETCH
Date s " 2 t, /1"
Construction Authorization Expiration Date: j" 0,7,r
HTE # 3Y38 6 e R Permit # P? 8 aZ 8 9
Harnett County Department of Riblic Health
Site Sketch
PROPERTY LOCATON:
ISSUED TO: SUBDIVISION LOT #
Authorized State Agent: 1:Z
Date:
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