IP ONLY NO AUTHORIZATION TO CONSTRUCTHTE# Io 5-a493 Harnett County Department of Public Health
Improvement Permit 2 6 2 4 0
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: ~l"-4 y a-, `--A C
ISSUED TO: \-I y tJ C c1 61, V CK V N SUBDIVISION -7-1 r-4 Q ~1~1 Qo 1 LOT # -c5i_
NEW REPAIR ❑ E ANSION ❑ Site Improvements required prior to Construction Authorization Issuan(e:
Type of Structure: `7 q:~D (-I'S -~O N PN o N
Ci Ea2 Q24,~N ~.E l O a'Er. ,
Proposed Wastewater System Type: `a50 to VGG~dN sls4Et~n
Projected Daily Flow: Y-C~' GPD N P2oP 05 ;Nt_, ,•s C L- Fr' ii~O-'L A ON t-\6w.
.
Number of bedrooms: 3 Number of Occupants: max h
Basement ❑Yes XNo ~Q ' cZw • G,
Pump Required: ❑Yes ❑ No X May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community 'X\ Public ❑ Well Distance from well 1 C) C) feet Permit valid for. Five years
Permit conditions: ❑ No expiration
Authorized State Agent: R.&1'6 Date: `R 1 16► \ 0 SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees th uan f 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 Improve 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, .1957, .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:
facility Type:
Basement? ❑ Yes ❑ No
Type of Wastewater System** _
(See note below, if applicable
Installation Requirements/Conditions
Septic Tank Size gallons
Pump Tank Size gallons
Pump Requirements: ft. TDH vs.
Conditions:
Number of trenches
Exact length of each trench
Trenches shall be installed on contour at a
Maximum Trench Depth of
(Trench bottoms shall be level to +/-1/4"
in all directions)
GPM
feet Trench Spacing: Feet on Center
Soil Cover 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 LOFT. 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 specified on the app/ication / accept the specifications of this permit
Owner/Legal Representative Signature: Date:
This Construction Authorization is subject to revocation if the site plan, plat, or the intended use changes. 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 Agent: Date:
Construction Authorization Expiration Date:
❑ New
Basement Fixtures? ❑ Yes
PROPERTY LOCATION:
SUBDIVISION
❑ Expansion ❑
❑ No
Repair
LOT #
(Initial) Wastewater flow: GPD