IPACHTE# 16-5-3`530 Harnett County Department of Public Health 29012
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
(� tgaJ PROPERTY LOCATION:_ O -
,
ISSUED TO: L- SUBDIVISION LOT #
NEW/ REPAIRd
4 ANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: SQ l60
Proposed Wastewater System Type: C -r-J6.,-a , T off a I
Projected Daily Flow: L1'60 GPD
Number of bedrooms:—�mber of Occupants: max
Basement ❑YesNo
Pump Required: ❑Yes o ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community �K Public ❑ Well Distance from well LO n feet ; Permit valid for. Xlive years
Permit conditions s ❑ No expiration
Authorized State Agent: �!Date:dl l {� SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the i tt of other permits. The permit holder is responsible r chxking 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 Impr Atent 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 Dispoml and to conditions of this permit.
Construction Authorization
(Required for Building Permit)
The construction and installation requirements of Rules .1958, .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: QXAF s `s I it1A� Jts Gucz,vzk PROPERTY LOCATION: C.urv,rx ,*41; s Qts
ll SUBDIVISION LOT #
Facility Type: 5F0 ��'c�CY )K New ❑ Expansion ❑ Repair
Basement? ❑ Yes )&Z No Basement fixtures? ❑ Yes XNo
Type of Wastewater System" Co,4v r—Nn t o N fit_ (Initial) Wastewater Flow: 4$ O GPD
(See note below, if applicable ❑)
C -0"'J, xv � o r NL (Repair)
Installation Requirements/Conditions Number of trenches t
Septic Tank Size too o gallons Exact length of each trench 533 feet
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of 3C — to inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
Pump Requirements: ft. TDM vs. GPM
Conditions:
Trench Spacing: 9 Feet on Center
Soil Cover. ate—tic inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
inches below pipe
Aggregate Depth: inches above pipe
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 system type specibed is different from the type spedhed on the app/kation. / accept the specifications of this permit
Owner/Legal Representative Signature: Date
This Construction "zalmn is subject m revocation if the site plan, plat or the intended use changes. The Construction Authorization shag out be transferred when there is a change in ownership of the site. This
construction Authrm tion is subject tir u 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 Agent: PL7) Date: `I —)Lk
Qnstruction Authorization Expiration Date: I)', I al
HTE# r�'5-3 °1530 Permit # a"1CJ12,
Harnett County Department of ll�iblic Health
Site Sketch
PROPERTY LOCATON: -+n1�11
ISSUED TO: ROO q Jo �v2UL..(- SUBDIVISION LOT #
Authorized State Agent: — (3 L)IGJ `T0L1C5nG,- + Date: 9��TI1 p
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