IPAC RRHTEOL"V-5--�c'ISP v, Hari. -,t County Department of Public ..ealth 28026
Improvement Permit
E SvsgN A building permit cannot be issued with only an Improvement Permit
�eSif3L: S1�dcnAYC—S7_ PROPERTY LOCATION: Sou)sj RL' ,&4-L.Q.O
ISSUED T0: SUBDIVISION — LOT #
NEW REPAIR ❑t EX ION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: SCO �aAS`6�
Proposed Wastewater System Type: e�5" o I) Jgc y a -s
Projected Daily Flow: GPD
Number of bedrooms: 3 Number of Occupants: b max
Basement ❑Yes No
Pump Required: Dyes No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community > Public ❑ Well Distance from well (3 feet Permit valid for. XI Five years
Permit conditions: �❑ No expiration
Authorized State Agent: Date: '8 I b ) SEE ATTACHED SITE SKETCH
e issuance of this permit by the Health Department in no way guarantees rhe Cher permits. The permit holders resp nsible for checking with appropriate governing bodies in meeting their requirements. This
site is tion if the sin plan, plat or the intended use changes. The I eme by sha a affected by a change in ownership of the site. This permit is subject to compliance with the provisions of
ws an ammnt and Disposal and cond"ons of his ermic.
npo v ur 6 9 n�
Construction Authorization
(Required for Building Permit)
The construction and installation requirements of Rules .1950..1952, .1954, .1955, .1956, .1957, .1959. and .1959 are incorporated by references into this permit and shall be met Systems shall be instilled in accordance
with the attached system layout 1
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ISSUED TO: PROPERTY LOCATION: S0VS`1'b
5Fq SUBDIVISION — LOT #
Facility Type: New ❑ Expansion ❑ Repair
Basement? ❑ Yes No Basement Fixtures? ❑ Yes " (Oo
Type of Wastewater System** Is- 0/1 Q�Ia.vUS 1 u N Sys-1Esr (Initial) Wastewater flow:GPD
(See note below, if applicable ❑)
&, Z /a 9-01)Vu )0 W (Repair)
Installation Requirements/Conditions Number of trenches
Septic Tank Size 10 0 0 gallons Exact length of each trench 12:0 feet Trench Spacing: `� Feet on Center
Pump Tank Size gallons Trenches shall be installed on contour at a Soil Cover. C —49 inches
Maximum Trench Depth of \% '30 inches (Maximum soil cover shall not exceed
(Trench bottoms shall be level to +/.I/4" 36" above the trench bottom)
in all directions)
Pump Requirements: ft TDR vs. GPM inches below pipe
Aggregate Depth: inches above pipe
Conditions: 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 ryrtem type speciled is different from the type ;pealed on the application. / accept the spechiicirronr of this permit
Owner/Legal Represen i nature: Date:
This Construction Authorization is subject in nell n e site plan, plat or the intended use changes The Cons n Aurha' tion shall not be transferred when there is a change in ownership of the site. This
Construction Authonzation i to romp i with th of the laws and Rules for Sewage Treactuxg and Dis conditions of this permit SEE ATTAINED SITE SKETCH
sl -slsa:
Date:
Con lion Authorization Expiration Date:
HTE# i�'� jL1'aA5M Permit # a�0-�,4
Harnett County Department of ll�iblic Health
Site Sketch oo
PROPERTY LOCATON:
ISSUED TO:°��_ Svs� S,-c�r,�1� SUBDIVISION LOT #
Authorized State Agent:
.).tts) )c
35' z�:
Date: \ I) A)S
IVA
51
� 3 x 60
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