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IPAC RHTE# /d 5oD V3z5/Z Harnett County Department of Public Health 28852 Improvement Permit A building permit cannot be issued with only an ]in rovement Pej�it PROPERTY LOCATION: Jeff [�L�C 10 St - ISSUED TO: Obe 5 SUBDIVISION TNOb/ le ,n n S LOT # NEW ❑ REPAIR fi' EXPANSION ❑ Site Improvements required prior to Constmction Authorization Issuance: Type of Structure: Q W M H & /2o oat, �. �� o C 4o,'s& A - J4-" Proposed Wastewater System Type: &0-4 -fQ EJ; 61v' u 0 Projected Daily Flow: 3 tm D GPD / Number of bedrooms: 3 Number of Occupants: b max Basement ❑Yes 5;40 Pump Required: L7fs Type of Water Supply: Permit conditions: ❑ No ❑ May be required bas on Final location and elevations of facilities El Community ❑ Public Well Distance from well S e) feet n Permit valid for. i19 Five years c I ae�ie^-Q S i.CL41f i f/o & A ' aj3n. tA'ex ❑ No expiation Authorized State Agent: 111[J4f3 Date: 0 � /.�eit9/�_ SEE ATTACHED SITE SKETCH The issuance of this permit by th partment in no ay guars the iuuanre 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 m conditions of this permit.. Construction Authorization Required for Buildine Permit The construction and installation requirements of Rules .1950, .1954 .1954, .1955, .1956, .1957, .1958. and .1959 are incorporated by references into this permit and shall be met Systems shall be imtilkd in accordance with the atached system layout /� ISSUED TO: RPS�J� ObL4 S PROPERTY LOCATION: S �e SUBDIVISION cv-4 /eea" LOT # Facility Type: A) /M/-{ ❑ New El Expansion C°3�Repair Basement? F-1Yes- 5;i -Mo Basement Fixtu es? ❑ Yes ❑ No Type of Wastewater System** �_/`„�, Y-Oit (Initial) Wastewater Flow: G © GPD (See note below, if applicable ❑) (Repair) Installation Requirements/Conditions Number of trenches Septic Tank Size Je0D gallons Exact length of each trench — feet Trench Spacing: Feet on Center Pump Tank Size f 0 ed gallons Trenches shall be installed on contour at a Soil (over. inches Maximum Trench Depth of: 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: (t. TDM vs. GPM Aggregate Depth: Conditions: 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. inches below pipe inches above pipe inches total **If applicable: / underrtand the t}rtem type spec/bed it different from the type Waled on the app/ication. / accept the rpea6cadonr 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 h a change in ownership of the site. This construction Authorization is Authorized State Agent: with the provisions of the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH H % Date: (0 5-1a/�O/� Authorization Expiration Date: HTE# M 670 3`d3.2 S-9 Permit # � !�? k 5 z Harnett County Department of Public Health Site Sketch PROPERTY LOCATON:_ A :�, ISSUED TO: e SSj C2 /w 5 /SUBDIVISION r LOT # _ ?— Authorized State Agent: ��71w� , L /� .� Date: e� 0akel L e 54. T 4,4-'y;•7 / -1 0 a67, y Ye oe 6 U