IPAC RHTE# Harrr..t County Department of Public _ealth 28102
Improvement Permit
A building permit cannot be issued with only an I ovement Permit
PROPERTY LOCATION: <..iZA
ISSUED TO: �F+w�E—ftc— Jr, 2Cyl brtir0'N SUBDIVISION r of�I a"t LOT # 0
NEW 0 REPAIR ❑ , EXPANSION'
❑ t Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: 1/4 Yl
Proposed Wastewater System Type:
Projected Daily Flow: 6 0 GPD
Number of bedrooms: Number of Occupants: _�jmax
Basement ❑Yes 210
Pump Required: []Yes
Type of Water Supply:
Permit conditions:
B* o ❑ Maybe required based on final location and elevations of facilities
❑ Community C7 Public ❑ Well Distance from well feet
Permit valid for.
2 f ve years
❑ No expiration
Authorized State Agent:. w �"Y ao �f�l Date: rZ ? 2c1J' 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 constriction and installation requirements of Rules .1958, .1951, .1954, .1955, .1956, .1957, .1958. and .1959 are incorporated by references into this permit and shall be met Systems shall be installed in acmrdance
with the attached system layout �a
ISSUED T0: �s'�-ec-1� Mei• `FO# A I rn PROPERTY LOCATION:
�� SUBDIVISION 11.rk �/ace LOT # /Or—
Facility 2
Facility Type: New ❑ Expansion ❑ Repair
Basement? ❑ Yes No Basement Fixtures? ❑ Yes ❑ No
Type of Wastewater System" �2S.7- (Initial) Wastewater Flow: `/8U GPD
(See note below, if applicable ❑)
ash jljt--(Repair)
Installation Requirements/Conditions Number of trenches /
Septic Tank Size 00 gallons Exact length of each trench ao0 feet
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of: /18 00 inches
(Trench bottoms shall be level to +/•1/4"
in all directions)
Pump Requirements: ft. TON vs. GPM
Trench Spacing. `% Feet on Center
Soil Cover. (, a� _ inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
pp Aggregate Depth:
Conditions: 15a,� /: � p� on C on,�'o o!
WATER LINES (INCLUDING IRRIGATION) MUST BE LOFT. FROM ANY PART OF SEPTI( SYSTEM OR REPAIR AREA.
NO UTILITIES ALLOWED IN INITIAL OR REPAIR DRAIN FIELD AREA.
inches below pipe
inches above pipe
inches total
""If applicable: / underhand the iptem type cpeciled it different /rota the type rpecif7ed on the app/kation. / accept the rpecilcatiom o/ thif permit.
Owner/legal Representative Signature: Date:
This Construction Authorization u subject in revocation if the site plan, plat or the intended use changes. The Construction Authorization shall not be transferred when there u a change in ownership of the site. This
constructions 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 AgenCw rte/% Date: 4 .i� /z�i/rr
Construction Authorization Expiration Date: 7 16 /N 4 z/J 2<zw
HTE# IV -J-- YAII�r-g Permit # 0 e 1 ca
Harnett County Department of Public Health
Site Sketch
PROPERTY LOCATON: Xd
ISSUED TO: SUBDIVISION /t9a� �f�o acc LOT #
Authorized State AgentCwc � Zfl Date:
( hZ 3 02�/l
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