IPAC RHTE# -I Harnett County Department of Public Health 28342
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
�} PROPERTY LOCATION: �iacc.y�; Cat tLC,rl
ISSUED TO: E tt;� `�`-- M )C2 Z- SUBDIVISION LOT #
NEWX REPAIR ❑ EXPSION I -]Type of Structure:0^
Proposed Wastewater System Type: Q -S o
Projected Daily Flow: Ulfalzlc GPD
Number of bedrooms: 1, Number of Occupants: _max
Basement ❑Yes XNo
Site Improvements required prior to Construction Authorization Issuance:
Pump Required: ❑Yes ?KNo ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community X Public ❑ Well Distance from well feet
Permit conditions:
Authorized State Agent:: 1_
The issuance of this permit by the Health Department in no way guarantees the iss
site is subject to revocation if the site plan, plat, or the intended use changes. The Impr
the Laws and Rules for Sewage Treatment and Disposal and to conditions of this permit..
Permit valid for:
,Five years
❑ No expiration
Date: 11i 11S- SEE ATTACHED SITE SKETCH
other permits. The permit ho er is responsible for checking with appropriate governing bodies in meeting their requirements. This
nent Permit shall not be affected by a change in ownership of the site. This permit is subject to compliance with the provisions of
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: 4a,;Q1--�M�cr .2 PROPERTY LOCATION: Q 4�11Q- C -C.0 C C� ki C
SUBDIVISION LOT #
Facility Type: s� '" -? 09 --8� New ❑ Expansion ❑ Repair
Basement? ❑ Yes —X No Basement F(j �tures? ❑ Yes N N
Type of Wastewater System* Z's Q(iC;—) t ON 5 -GM (Initial) Wastewater Flow: �6 GPD
(See note below, if applicable ❑)
&4 Flo oA 1 (Repair)
Installation Requirements/Conditions Number of trenches
Septic Tank Size ►06 gallons Exact length of each trench 0
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of: Q'�
Pump Requirements: ft. TDH vs.
Conditions:
(Trench bottoms shall be level to +/-1/4"
in all directions)
GPM
feet Trench Spacing: 9 Feet on Center
Soil Cover: 1', inches
inches (Maximum soil cover shall not exceed
36" above the trench bottom)
Aggregate Depth:
inches below pipe
inches above pipe
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 specifled on the application. / accept the specifIcations of this permit.
Owner/legal Representative Signature: Date:
This Construction Authorization is subject to reva . 'f the si a 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 subj t mpliance wi a Prov a Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent: Date: 9 }� }
Construe % Authorization Expiration Date: 6 Y
HTE# Permit #
Harnett County Department of Public Health
Site Sketch
PROPERTY LO(ATON:C--C,
ISSUED TO: SUBDIVISION LOT #
Authorized State Agent: L)-4 6fC701-\(---X 6ate: C 1.6 ),S-
D-1,213 /
I
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