IPACHTE# tS--�-�- `367 Harnett County Department of Public Health 28496
hDrovement Permit
A building permit cannot be issued with only an, Improvement Permit
PROPERTY LOCATION: Z
ISSUEDTO / SUBDIVISION I•)UCIk-I r&t—LOT #
NEW REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure:
Proposed Wastewater System Type: ?;` a ila f
Projected Daily Flow: GPD
Number of bedrooms: Number of Occupants: max
Basement ❑Yes FNo
Pump Required: ❑Yes ElNo 13--M�4yk required based on final location and elevations of facilities
Type of Water Supply: ❑ Community ff Public ❑ Well Distance from well feet Permit valid for: Five years
Permit conditions: ❑ No expiration
AuthorizedStat n • Date: Ct -- f — t �^ SEE ATTACHED SITE SKETCH
The issuance of this permit th ealth 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 revocati ' t e 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: d"�t1 PROPERTY LOCATION: Z-
SUBDIVISION,f�✓cam/�7?�?� LOT #
facility Type: C" New F-1Expansion❑ Repair
Basement? ❑ Yes El"'No Basement Fixtures? ❑ Yes Ealo—
Type of Wastewater System** ZS �a t`YH�'�L ------ �i,J 4-k — (Initial) Wastewater Flow: GPD
(See note below, if applicable ❑)
Z:S% �r Zt 3 9-- (Repair)
Installation Requirements/Conditions Number of trent es N
Septic Tank Size —7 gallons
Pump Tank Size gallons
Pump Requirements: ft. TDH vs.
Conditions:
Exact length of each trench 'o feet
Trenches shall be installed on contour at a
Maximum Trench Depth of: 2Z-519 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)
6 inches below pipe
Aggregate Depth: inches above pipe
inches total
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: /under tend the system type speciled is different from the type specified on the app/ication. / accept the specifications of this permit.
Owner/Legal Representative Signature: Date:
This Construction Authorization is subiect to revocation if the site plan, plat. or the intended use chances. The Construction Authorization shall not be transferred when there is a chance 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 A Date:
Construction Authorization Expiration Date: 5— f — Z.n
_ Z8
HTE# b Permit #-
Harnett County Department o clic Health
Site Sketch
/ PROPERTY LOCATON:(/Z—
ISSUED TO: �/ d" SUBDIVISION LOT #
Authorized State aent- Date: c
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