IPAC RHTE# Harnett County Department of Public Health
Improvement Permit 2 6 2 7 7
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: C~tr,~cz c> N PIN l~S O
cz-
ISSUED TO: NI c~ rr C-i cLV LN n r,t SUBDIVISION C Psct o P s t:5 LOT #
NEW\64 REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure:
Proposed Wastewater System Type: Qur,e 'CQ 5% SZ~o e
Projected Daily Flow: 3~0 GPD
Number of bedrooms: - Number of Occupants: j~7 max
Basement ❑Yes '-54No
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 1O 0 feet
Permit conditions:
Permit valid for. Five years
❑ No expiration
Authorized State Agent.: Q.E:a Date: > NO SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the issuance o r 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 to conditions of this permit.
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: `1 r.t tJ Co T- ;ctv (::!v, o r PROPERTY LOCATION: Car,~t~ o N P ) N E~ ~2
SUBDIVISION C Pre r cz aN
Facility Type: ~t-tN'x-n~ xy New ❑ Expansion ❑ Repair LOT #
Basement? ❑ Yes X No Basement Fixtures? Yes V No
Type of Wastewater System** Pv Me o -aJ ! o vc;-~ t drat Serfs c r<r (Initial) Wastewater Flow: GPD
(See note below, if applicable
PV -,e o W/o KE~U L'scy 1J (Repair)
Installation Requirements/Conditions Number of trenches P,
Septic Tank Size In0c) gallons Exact length of each trench 5~ feet Trench Spacing: Feet on Center
Pump Tank Size ooo gallons Trenches shall be installed on contour at a Soil Cover. C -a `h inches
Maximum Trench Depth of. 1$ `3Ca inches (Maximum soil cover shall not exceed
(Trench bottoms shall be level to +1-114" 36" above the trench bottom)
in all directions)
Pump Requirements: ft. TDH vs. GPM inches below pipe
Aggregate Depth: inches above pipe
Conditions: Q Q2oe os~ o t-, Leo t . c,c s inches total
S CD 1 L. S G1 'Iv--N-"~ \ 'G(
WATER LINES (IN(LUDING IRRIGATION) MUST BE ]OFT. 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 specified it different from the type rpecired on the app/ication. /accept the rpeci<cationf of thi permit.
Owner/Legal Representative Signature: Date:
This Construction Authorization is subject to re it if the ite plan, 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 sub~ect to compli with he sin f the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent:, Date: ko
Co ction Authorization Expiration Date: _
NTE # t O S 1'a~
Permit # `I
Harnett County Depailment of Miblic Health
Site Sketch
PROPERTY LOCATON: C-o.h,LCL s J P~.4FF, ~!L
ISSUED TO: ~r ~,a 5 ; v ca:~ a c f SUBDIVISION GP.c,~Ao j,.j P~ ifs LOT # ~o
Authorized State Agent: c ti o w ~n ;oiK~wc~ Date: A0~ )~)o
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Department of Emrironment, Health and Natural Resources Sheet:
Division of Environmemal Health Property ID:
On-Site Wastewater Section Lot a:
SOIUSM )EVALUATION File a:
f Code:
or ON-91(TB WASTMATiER SYST>tM=
Owner. Applicant:
Addrem Date EvaltWed: 0i)3 dl
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Property' Size:
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Pmoerty, Recorded:
Water Sup* ~ ftlk ❑ Individual ❑
Well ❑ Siring
Evaluation Method: Auger Boring 0 Pit
Type of Wastewater
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ewage ❑ Industrial Pmcess
Mixed
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