IPACHTE#_ Harnett County Department of Public Health 2 3 5 9 7
Improvement Permit
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bm-Idmg pe it cannot be issued with only an Improvement Permit
PROPERTY LOCATION Y~ 12 3
ISSUED TO: L ~ err ~`s SUBDIVISION CAIVAft-, JMc-1`6 4,3 f Q~, In LOT #
NEW` [PAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization I suance:
Type of Structure: A S~ Ns? °f EX\S-ts+,u T/jinh LVA) t J's ,mod 4
Proposed Wastewater SystVD, e:
Projected Daily Flow: 4c GPD ~~~~c(r 1 QUryr:,„ %is•f2 ~(R Lz
Number of bedrooms: Number of Occupants: max
Basement ❑Yes No (~u,KL Al ~c^n (a•
Pump Required*es ❑ No ❑ May be required based on final location and elevations of facilities
Type of Water Supply ❑ Community Public ❑ ell DistancR from well feet Permit valid for. Five years
Permit conditions: rt a , r i' i l /L €F, n , Id ❑ No expiration
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Authorized State Agent:: Date: D-7- o~ ~1 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 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
Reouired 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 accord nce wit the attar ed system layout.
ISSUED TO: or`r.l PROPERTY LOCATION: R
SUBDIVISION Cc-1)_ VAr f'11 ~ off, z - C we LOT #
Facility Type: ! EA J
- New ❑ Expansion ❑ Repair
Basement? ❑ Yes 9 No Basement Fixtures? ❑ Yes F 1Ao
Type of Wastewater System** Eimer-~ T-,-),1L,,, ,,,,P- (initial) Wastewater Flow: (0 Q GPD
(See note below, if applicable
(Repair)
Installation Requirements/Conditions
Septic Tank Size 0Z 0 gallons Exact length of each trench feet
Pump Tank Size 1333 gallons Trenches shall be installed on contour at a
Pump Requirements: ft. TDH vs.
Conditions:
Maximum Trench Depth of: inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
GPM
Trench Spacing: Feet on Center
Soil Cover. inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
inches below pipe
Aggregate Depth: inches above pipe
inches total
**If applicable: / understand the system type specified a different from the type specified on the app/icatioo. / accept the specifications of this permit.
Owner/Legal Representative Signature: Date:
finis c.onnrucrwn Motorization is suolect to revocation it the site plan, plat, or the intended use changes, the Lonstruction 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 Agent. Date: &
(onstruction Authorization Expiration Date: ~`~"r► a~~~
HTE# L-<DO o~ Permit
Harnett County Depairlinent of 11t-tbli c Health
,Qnu.x- etc-~,st Chur~:~h Site Sketch
CQ.~Yar~ ill,tss ~ N~,
PROPERTY LOCATON:Sf- tzo,)
ISSUED TO: (2~}!l4Vp, Aloe -L„ SUBDIVISION C4 10 e4v I'C _ LOT #
Authorized State Agent:
fl-o
Date: - d ~ - /J
X 12D-)
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