IP ONLY NO AUTHORIZATION TO CONSTRUCTHTE# E C).- 5 - Dz-N93(, Harnett County Department of Public Health
Improvement Permit 26241
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: ~-lw 1 '3rD G5`N
ISSUED TO: \vJ yrJ 0 CO~tS'c itVC.,-«0 N ~N L SUBDIVISION 1 .e.3 poi ..,~G LOT # O 1
NEW'X REPAIR P EX4NSION ❑ Site Improvements required prior to Construction Authorization Issuanc
Type of Structure: `5V-~ S -A-~Q
Proposed Wastewater System Type: c tuoOUCIT 1 r~ rr S-)5~Ery~
Projected Daily Flow: 25 GPD o.~f~ 0 GeV Qa-of0Ss:.L. NENcc OFD= ~2A~>J
Number of bedrooms: 3 Number of Occupants: max
Basement ❑Yes "L<No T71 E)-y VtL6 t"
Pump Required: ❑Yes El No May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community Public ❑ Well Distance from well 10 feet Permit valid for. Five years
Permit conditions: ❑ No expiration
Authorized State Agent:: RC-\~sS Date: 'R I \ 010 SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the i e 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, pla4 or the intended use changes. The Imps ment 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 ]OFT. FROM ANY PART OF SEPTIC SYSTEM OR REPAIR AREA.
NO UTILITIES ALLOWED IN INITIAL OR REPAIR DRAIN FIELD AREA.
"If applicable: /under understand the system type specified is diNerent from the type specified on the app/ication. / accept the speciflwionr 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 change in ownership of the site. This
Lonstruction 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 C
❑ No
Repair
LOT #
(Initial) Wastewater Flow: GPD