IPAC RHTE# //o—S 3xs2gR Harn,c County Department of Public t,,alth 28855
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION—Sil{43�—/% 4 a k19C::`
ISSUED TO/ A .0 ((t, SUBDIVISION f IR+ �fa/�.rr rv! n�lr,[+,r,r2 " LOT #
NEW fPAIdR�❑� EXPANSION ❑ Site Improvements required prior to onstruction Authorization Issuance:
Type of Structure:
Proposed Wastewater System T pe: S� {
Projected Daily Flow: —U GPD
Number of bedrooms: ai Number of Occupants: max
Basement
Basement ❑yes �Istlio
Pump Required: Ca}Tes ❑ No ❑ May/be required based on final location and elevations of facilities — //
Type of Water Supply: El Community Community I Public ❑ Well Distance from well feet Permit valid for. l:34rye years
Permit conditions: ❑ No expiration
Authorized State A Date: m� SEE ATTACHED SITE SKETCH
The issuance of this permit by a ealth 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 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 pmvisions of
the Laws and Rules for Sewage Treatment and Disposal and to conditions of this permit.
Construction Authorization
squired for Building Permit)
The construction and installation requirements o1 Rules .1950, AM, .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 TOI�/%fir PROPERTY LOCATION: �%' A�D
SUBDIVISION —3
.rT ✓Fw a �0f_ �e LOT # —3Facility Type: S � 51 New ❑ Expansion ❑ Repair
Basement? ❑ Yes EY No Basement Fixtures? ❑ Yes ❑ No
Type of Wastewater System**Iw p i fl 5�%Li2Gt�V 7 Lee G._`f 6� (Initial) Wastewater flow: 3_(06 GPD
(See note below, if applicable 01
r�r� Za`�oj?$Lb)11�Cu�Repair)
Installation Requirements/Conditions Number of trenches
Septic Tank Size 7 gallons Exact length of each trench Z O feet Trench Spacing: Feet on Center
Pump Tank Size / DOb gallons Trenches shall be installed on contour at a Soil (over: inches
Maximum Trench Depth of: L.� —> 19, inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
Pump Requirements: ft. TDH vs. GPM
Conditions:
(Maximum soil cover shall not exceed
36" above the trench bottom)
Aggregate Depth:
WATER LINES (INCLUDING IRRIGATION) MUST BE IOFL FROM ANY PART OF SEPTIC SYSTEM OR REPAIR AREA.
NO UTILITIES ALLOWED IN INITIAL OR REPAIR DRAIN FIELD AREA.
Y inches below pipe
Z inches above pipe
inches total
If applicable: / understand the tyttem t}pe JpetiheJ it different horn the type tpecibed on the app/kation. /accept the JpeciScatianr of this pemli
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 shill not be transferred when there is a change in ownership of the sire. This
Lommuccun numoneanon 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 AI IACHED SITE SKETCH
�� co
Authorized State A Date:
!/ Construction Authorization Expiration Date:/
NTE# 3Permit # z 08 's s k
Harnett County Department of 1'nblic Health
Site Sketch
PROPERTY LO(ATON:a/1_! N3si �r./J� /,CA
ISSUED TO: /I./rr 15ns /%,a., ZLS,.. SUBDIVISION LOT # _
Authorized State Eur_ .v Date: S x sYo
5-34C,
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