IPAC RRHTE# Q7-S-- i8sio~2Harnt<< County Department of Public i-. alth 24401
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
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( PROPERTY LOCATIOA-24J
ISSUED T0: c/r9CD b ~i4L/Dh/ SUBDIVISION l~
.~st/,CS LOT # _
NEW REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: :'G4)
Proposed Wastewater System Type: 2575
Projected Daily Flow: 360 GPD
Number of bedrooms: Number of Occupants: Amax
Basement ❑Yes No Z May Required: ❑Yes ❑ No IQ ;I-Plu a required based on final location and elevations of facilities
Type of Water Supply: ❑ Community blic ❑Well Distance from well feet Permit valid for. ive years
Permit conditions: ❑ No expiration
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Authorized State Ag Date: /D'3y 1'7 SEE ATTACHED SITE SKETCH
The issuance of this per 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 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
Reouired 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: ~7ACp,6 Lem PROPERTY LOCATION: ,J
SUBDIVISION Y1 LOT # 7
Facility Type: sf l4 New xpansion ❑ Repair
Basement? ❑ Yes 0 No Basement Fixtures? ❑ Yes L/J No
Type of Wastewater System** 7Si'1~2~z~jKj Ss F~y~..pnitial) Wastewater Flow: 360 GPD
(See note below, if applicable
Z06d?! r :5 (Repair)
InsiglMon RNuirawnts/Conditions
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Septic Tank Size 146 ,0 gallons Exact length of each trench ! z v feet Trench Spacing: feet on Center
Pump Tank Size gallons Trenches shall be installed on contour at a Soil Cover. inches
Maximum Trench Depth of: IS-)IS 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
Conditions:
Aggregate Depth:
inches below pipe
_ of inches above pipe
_2 inches total
**If applicable: l understand the system type specified is different from the type specified on the application. / accept the specifications of this permit.
Owner/Legal Representative Signature: Date:
ID WMIUuwo HmnuncaUm1 n =lea to revocation a me site plan, plat, or the mtenhea use changes. the Lonstrucnon Authorization shall not be transferred when there is a change 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 Ag t: Date: /U y 7 ~`~al//f
Construction Authorization Expiration Date: /v 3 ! Z /an
NTE# 0-7 - 5--- /,9-776/Z/? Permit # Z Y L/D /
Harnett (bounty DepaAment of Miblic Health
Site Sketch
_ PROPERTY LOCATON: yd/,d
ISSUED TO: SUBDIVISION .s/#LOT #
Authorized State Age ~ Date: 8 -ZD -t v
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