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HTE# o-s ,a Harnett bounty Department of Public Hearin 2 613 5
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
1 ` PROPERTY LOCATION: HI aO \4
ISSUED TO: t' rArnCLICIP-44 ~kOMESM SUBDIVISION pp s,jm LOT # I_
NEW REPAIR ❑ PANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: S ~
Proposed Wastewater System Type: stl,,, ST.
Projected Daily Flow: GPD is Number of bedrooms: Number of Occupants: is max
Basement ❑Yes No
Pump Required: ❑Yes ❑ No May be required based on final location and elevations of facilities
Type of Water Supply: Community Public ❑ Well Distance from well
_lCC) _ feet Permit valid for. five years
Permit conditions:
❑ No expiration
Authorized State Agent:: _ 4 U-)
The issuance of this permit by the Health Department in no way guarantees he ' ce
site is subject to revocation if the site plan, plat, or the intended use changes. The Im
the Laws and Rules for Sewage Treatment and Disposal and to conditions of this permit.
5 Date: _CI 1~I\0 SEE ATTACHED SITE SKETCH
of other permits. The permit hol r is r ponsible for checking with appropriate governing bodies in meeting their requirements. This
vement Permit shall not be affected by a change in ownership of the site. This permit is subject to compliance with the provisions of
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: NMeXZ\C, PROPERTY LOCATION: )A-"m
SUBDIVISION C+Ety ~ 0) -1"1 f
Facility Type: S~ L' LOT #
New ❑ Expansion ❑ Repair
Basement? ❑ Yes ~ No Basement Fixtures? ❑ Yes Clo
Type of Wastewater System** 25 /a RGzo<::~--,N Q o S yS'r'Er , (Initial) Wastewater Flow: 2O GPD
(See note below, if applicable
C)&,e ~Q ,~AZsOt f nre yl6wo6s+y(Repair)
Installation Requirements/Conditions Number of trenches 1
Septic Tank Size I co o gallons Exact length of each trench a.S5 feet Trench Spacing: Feet on Center
Pump Tank Size gallons Trenches shall be installed on contour at a Soil Cover 6 inches
Maximum Trench Depth of: 11 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 inches below pipe
Aggregate Depth: inches above pipe
Conditions: W..: En LN ..s sK (~,G. Faun, S "c, S7'5's EM. N o Ut LNS •E5 MPsy
E c oA inches total
c, N 1 ~ ~ -r ~ t_ ~p a ~ cc. P~ A. ; , P~,r• ,S a ~ O a Psw t~ oS ~ Fa,d t•. ~e L,c.c,^rt'
**If applicable: / anderstand the system type specified it different from the type ,rpecibed on the app/ration. / accept the .rpeciflwionr of this permit.
Owner/legal Representative Signature: Date:
This Construction Authorization is subject to re . if the site plat, or the intended use changes. The Construction Authorization shall not be transferred when there is a change in ownership of the site. This
Construction Authorization is Ttkct compliance w e o caws and Rules for Sewage Treatment and Disposal and to the conditions of this permit. SEE ATTACHED SITE SKETCH
Authorized State Agent:
Res Date: d q- 3.. /0
114 J5
t ion Authorization Expiration Date: C,
~
HTE # l 0 S-a3-15~ 2 Permit # l3 5
Harnett County Department of Public Health
Site Sketch
PROPERTY LO(ATON:
ISSUED TO: \-~nML75M N~ SUBDIVISION LOT #
Authorized State Agent: i~5 QC Ltiv Exp. -To t-*-t, Date: C~
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LEGEND
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