IPAC RHTE# rd-J-- Harnett County Department of Public Health 2 6 1 g 7
Improvement Permit
A building permit cannot be issued with only. an Im rovement Pgtmit
ISSUED TO- C PROPERTY LOCATION: c f~ ' lac ~Q~t
~ o~I~~ ~ S t~Ja,flQC
NEW L~f REPAIR ❑
LOT #
EXPANSION lt [I SUBDIVISION Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: j
Proposed Wastewater System Type: Projected Daily flow -3 (a0 GPD
Number of bedrooms: pl~ka Nu mber of Occupants: Basement ❑Yes max
Pump Required: ❑Yes ET No ❑ Ma~e required based on final location and elevations of facilities
Type of Water Supply: ❑ Community PUbhC ❑ Well Distance from well
Permit conditions: feet Permit valid for.
~F~ive years
❑ No expiration
Authorized State Agent:: Z
SEE ATTACHED SITE SKETCH
f•^ n + l rr If The issuance of this permit by the Health Department in no way guarantees the issuance of other 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 thetprovisions of
the Laws and Rules for Sewage Treatment and Disposal and to conditions of this permit.
Construction Authorization
The construction and installation requirements of Rules .1950, .1952, .1954, .1955, .1956tRequired
.1959 Building
958. and for
are incorporated )
with the attached system layout by references into this permit and shall be met. Systems shall be installed in accordance
ISSUED T0: "c 01",r 'j-' wtm"k_
Facility Type: G D E?-"New
Basements ❑ Yes C+r No Basement Fixtures? ❑ ~}!,Ps
Type of Wastewater System** (c ,/e
(See note below, if applicable
PROPERTY LOCATION:
SUBDIVISION
❑ Expansion ❑ Repair LOT # f
❑ No
(Initial) Wastewater flow: _ ~ GPD
C.c`'1,V,'_ (Repair)
Installation Requirements/Conditions
Number Tank Size O ~C~ of trenches
gallons Exact length of each trench __,25feet
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of. l -,30 inches
(Trench bottoms shall be level to +1_114-
Pump Requirements: in all directions)
ft. TDH vs. GPM
E_4=~J l e E
ta...,tc~ :n 1a!
c/' Fr
**If aoalicable_/ onderrtand the Yryvem type tpecihed it different from
Trench Spacing: 7 feet on Center
Soil Cover: 6 - f8 inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
3 Aggregate Depth:
C) ; ~ /1c~~cmt /tes cue
inches below pipe
inches above pipe
12- inches total
type speciled on the application. / accept the .rpecilcationr of this permit
Owner/legal Representative Signature:
This Construction Authorizagon is subjea to revocation if the site plan, play or the intended use changes. The Construction Authorization shall there Date:
is a change in ownership o1 the site. This
Construction Authorization is subject to not be transferred when h compliance 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
Date: C /0
72Go- a
Construction Authorization Expiration Date: C~
HTE#~ 2-- 7 X
Permit #
Harnett (ionnt`T I)epaljment of tblic
Health
Site Sketch
ISSUED T0: PROPERTY LOCATON: Cover. , 5~
SUBDIVISION
LOT #
Authorised State Agent: Date: 1a11'31o
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