IPAC RHTE# 16-53'S9o5(Z Harnett County Department of Public Health 29112
Imarovement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: 1lcoChEt2. oufl O2_
ISSUED TO: SUBDIVISION a—, LOT #
NEWX REPAIR 4 EN SION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: Steri \G3 XS$
Proposed Wastewater System Type: -\879 PFougsSi is ofS�'STeS�t1
Projected Daily Flow: S;' 4z) GPD
Number of bedrooms: Number of Occupants: —max
Basement ❑Yes >No
Pump Required: ❑Yes ❑ NoPtay be required based on final location and elevations of facilities
Type of Water Supply. ❑Community -� Public ❑ Well Distance from well I r) O` feet Permit valid for. XFive years
Permit conditions: ❑ No expiration
Authorized State Agent: W Date:I s 1+ SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the i y(, -of other permits. The pemdt holder is esponsible for checking with appropriate goveming 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 he met Systems shall be installed in aaordance
with the attached system layout
ISSUED T0: 0 CIC—Z 1\OMEe9 PROPERTY LOCATION: "CESM tL-eaOoD �)Q
SUBDIVISION OP syo LOT # Y�
Facility Type: SAO C�13'cS�( New ❑ Expansion ❑ Repair
Basement? ❑ Yes � No Basement Fixt res? 11Yes N0
Type of Wastewater System** aS°lo 6oucs, Sg=z5TF.n (Initial) Wastewater Flow: GPD
(See note below, if applicable ❑)
r0 �EO• Sy5 - (Repair)
Installation Requirements/Conditions Number of trenches
Septic Tank Size v 0 O d gallons Exact length of each trench feet
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of. 1I inches
(Trench bottoms shall be level to +/-I/4"
in all directions)
Pump Requirements: fL TOM vs. GPM
Conditions:
Trench Spacing: Feet on Center
Soil Cover- inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
Aggregate Depth:
WATER LINES (INCLUDING IRRIGATION) MUST BE IOFT. 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: / understand the system type specified it different fom the type spedfed on the application. / accept the spedfcadons o/this pemzit.
Owner/Lego ntative Signature: Date
This construction Authorization is su revocation if the site plan, plat or the intended use changes. The Construction Authoritarian shall not be transferred when then is a change in ownership of the site. This
construction Authofieatio t m complian e p ns of the taws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent: W-16 Date: Wk/'
ction Authorization ExOiration Date: 1
NTE# 3'V�d5Q- Permit # ZL�li'Z.
Harnett County Department of Public Health
Site Sketch
ISSUED T0: M s-_1 --E
Authorized State Agent:
PROPERTY LOCATON: 0 4 O � -
SUBDIVISION PY S ,O N , LOT # t' it
CO L)
YOS
Date: `) ) q
Z