IPAC RRRRNTE# 2E—e-- arl._dt County Department of Public ..ealth 28289
Improvement Permit
A'e,'�+ S�f A buildi� ermit cannot be issued with only an Improvement Permit
r �PRnorary i nrennu• i t% rc� X A
ISSUED TT0/: f nate �', [ C-aX SUBDIVISION LOT #
NEW L�' REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: -) ay Q , e eta 1C7t�
Proposed Wastewater System Type: Pj
Projected Daily Flow: GPD3"� r`
Number of bedrooms: Number of Occupants: E? `--V L_y max
Basement ❑Yes VNo
Pump Required: 113 es ❑ No ❑�MaY be required based on final location and elevations of facilities
Type of Water Supply: 11 Community LJ Public ❑ Well Distance from well feet Permit valid for: Five years
Permit conditions: ❑ No expiration
Authorized State Agent:: —Z / -:_'-Z6gly Date: 7FI=ZvIr— G (S/:Zc/ 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: ai v UJ C C ;C PROPERTY LOCATION: z—ae ( J c,L ,y a x. ,2d
SUBDIVISION LOT #
Facility Type: bGi/ C rL T New ❑ Expansion ❑ Repair
Basement? ❑ Yes b No Basement Fixtures? ❑ Yes ❑ No
Type of Wastewater System** Lll"P'k (Initial) Wastewater Flow: 8 7 GPD
(See note below, if applicable ❑) pp
7��P�.ve:1.(Repair)
Installation Requirements/Conditions Number of trenches 7$t,
Septic Tank Size ' fesgallons Exact length of each trench -4ttt— feet Trench Spacing: Feet on Center
Pump Tank Size 5—r,
_G gallons Trenches shall be installed on contour at a Soil Cover: (0 inches
Gre'J-'_T"q /000 Ya It°" Maximum Trench Depth of: /8-3a 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 Aggregate Depth: inches above pipe
Conditions: J_t- o �: c C'c., n c �cr «� oK 1a f L -�- ye-r"7`v dP a �C %«/ 12— inches total
l av .rvii,(e
WATER LINES (INCLUDING IRRIGATION) MUST BE 10FT. FROM ANY PART OF SEPTIC SYSTEM OR REPAIR AREA.
NO UTILITIES ALLOWED IN INITIAL OR REPAIR DRAIN FIELD AREA.
**If applicable: l understand the system type rpeciled is different from the type speciled on the application. l accept the specilcations of this permit.
Owner/Legal Representative Signature: Date:
This Construction Authorization is subiect to revocation if 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 subject to complian with the provisions of the laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit. SEEATTACHEDSITE SKETCH
Authorized State Agent- c 2c' l Date: r z�_
Construction Authorization Expiration Date: ' t� u'zc3
HTE# /Vl.S=„,7 7-6G //?- 4 JL Permit # j &,z b i
Harnett County Department of ublic Health
Site Sketch
PROPERTY LOCATON: J Ge—
ISSUED
e ISSUED TO: �� ; �c SUBDIVISION LOT #
Authorized State Agent: ` wG , �{% Date:2 1-,(T j� /� `G4.S'_
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