IPAC RRHTE# 10-5- D, Li P_Z Harnett County Department of Public Health
Improvement Permit 2 6 2 9 0
A building permit cannot be issued with only an Improvement Permit
p PROPERTY LOCATION: N (-,1 p
ISSUED T0: ~?P,c~ ) ~Oglasa~f ~pt ~r~5 SUBDIVISION GwEsJ 0
NEW REPAIR El EXPANSION El LOT
Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: S ~ S] ~ S p "x~
Proposed Wastewater System Type: a N S "vs"M"
Projected Daily flow: i GPD
Number of bedrooms: 3 Number of Occupants: C, max
Basement ❑Yes No
Pump Required: ❑Yes i< No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community X Public 1:1 Well Distance from well
100 Permit conditions: feet Permit valid for. 'Five years
❑ No expiration
Authorized State Agent:: L-)~
The issuance of this permit by the Health Department in no way guarantees site is subject to revocation if the site plan, plat, or the intended use changes. The m
the Laws and Rules for Sewage Treatment and Disposal and to conditions of this permit.
Date: l', i5 ~ )0 SEE ATTACHED SITE SKETCH
oof other permits. The permit holder is resp Bible for checking with appropriate governing bodies in meeting their requirements. This
vement Permit shall not be affected by a change in ownership of the site. This permit is subject to compliance with the provisions of
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 instafled in accordance
with the attached system layout. pp
ISSUED T0: et a~NSd N Hp~t ~S PROPERTY LOCATION: NC. ),AO
SUBDIVISION GwEs~ C}sa~5 OT # ~a
Facility Type: SVO(J do New F1 Expansion El Repair L
Basement? ❑ YesI No Basement Fixtures? ❑ Yes No
Type of Wastewater System** 5~/~o~rs s ct s
(See note below, if applicable (Initial) Wastewater flow: 6 GPD
_ '~L0 Pv _ev ;Nt e sJ 5-Y-5-8 Em (Repair)
Installation Requirements/Conditions Number of trenches I_
Septic Tank Size ) 00C gallons Exact length of each trench 'Zk`1 5 feet
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of. 11 inches
(Trench bottoms shall be level to +1-114"
in all directions)
Pump Requirements: ft. TDH vs. GPM
Conditions: _M EC-5 O , 5
014 f'rw-4?0- ,i- ~ N, Q Ls5
Trench Spacing: Feet on Center
Soil Cover. G inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
inches below pipe
Depth: inches above pipe
- inches total
WATER LINES (INCLUDING 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 system type rpeciled is different from the type specified on the app/ication. / accept the rpecil2w ns of this permit.
Owner/Legal Representative Signature:
This Construction Authorization is su le ation if the site
Construction Authorization is Qk~o compliance
Authorized State Agent:
Date: _
or the intended use changes. The Construction Authorization shall not be transferred when there is a
and Rules for Sewage Treatment and Disposal and to the conditions of this permit.
Date: t 0115 hD
e in ownership of the site. This
SEE ATTACHED SITE SKETCH
Constru Authorization Expiration Date: ' I o rl ?6'~
HTE# 10-- Permit # QG3-) 0
Harnett County Department of Public Health
Site Sketch
PROPERTY LOCATON: t, iC. -,),10
ISSUED T0: G. n1Fs SUBDIVISION ~viEn1 Oo, LOT #
Authorized State Agent: Y iV ~1L '!'Ot Ct Date: t C~ ZS }