IPAC RHTE#_ Q S" , IO Y M Harnett County Department of Public Health 2 35 9 9
Improvement Permit
A building permit cannot be issued with only an mprovement Permit
PROPERTY LO(A ION• L/D C R3 --17 -4
ISSUED TO: A(2 P-06I 3/VlC-t SUBDIVISION 0/0/) 1 A ( 8I S LOT # 31
NEVI EPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: )L -5F0 - - 2
Proposed Wastewater System Type:
Projected Daily Flow: €vw x GPD
Number of bedrooms: Number of Occupants: max
Basement ❑Yes ` No
Pump Required: ❑Yes ❑ No -May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community A- Public ❑ Well Distance from well feet Permit valid for. Five years
Permit conditions: [11,ee- OO,ts Gr- .F,na,,( a t~ 574 PkM tl Y ❑ No expiration
of utc,- Gr r.c
Authorized State Agent: Date: aw SEE ATTACHED SITE SKETCH
The issuance of this permit by a 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 Buildine 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 with the attached s stem layout,
ISSUED T0: s <ew- PROPERTY LOCATION: J36 Zil A
SUBDIVISIONS C'~ ~N, N ( p(. / i s' LOT # f
Facility Type: F0 C- j D Y JN 1~z New ❑ Expansion ❑ Repair
Basement? ❑ Yes `Eg(- No Basement Fixtures? ❑ Yes SJ:-Tdo
Type of Wastewater System" '6z c f,-.n (Initial) Wastewater flow- . 3 nom. GPD
(See note below, if applicable
UT (Repair)
InMation Requirments/Cond'ttions
Septic Tank Size 000 gallons Exact length of each trench feet
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of: inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
Pump Requirements: ft. TDH vs. GPM
Conditions:
Trench Spacing: C'Y Feet on Center
Soil Cover. ~nches
(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 is different from the type specified on the app/icatian. /accept the pecifications of this permit.
Owner/Legal Representative Signature: Date:
TL; r
~U VII•S IV" 14 >U1.1- LV IC.VULIU[i UlC Mt! Plan, pia,, or me mrenaea use cnanges. ine construction Authorization shall not be transferred when there is a change in ownership
of the site. This Construction Auth tion is subject to compliance with the provisions of the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit
SEEATTACHED SITE SKETCH
Authorized State Agent: pf~'ff~ Date: 0 0)') It7
Construction Authorization Expiration Date: ' o I - / S"
HTE# 06-5013-- Permit # x3597
Harnett County Department of 1-iib is Health
Site 'Sketch
u PROPERTY LOCATON: ~Cx _f Qz~.Ckj
ISSUED TO: (21 SUBDIVISION n C f LOT # 1
Autho ized State Agent: = 1'f-f Date: QV 01 - ~ J
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