IPAC RHTE# 10-s-;0'"Z$L X Harnett County Department of Public Health 26198
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATI C I U~ LI ISSUED TO: SUBLOT #
NEW REPAIR ❑ EXPANSION El Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: d k,, 0
Proposed Wastewater System Type: C ca A VC -A :rt
Projected Daily Flow: '7(1 0 _ GPD
Number of bedrooms:- 3-~--- Number of Occupants: max
Basement ❑Yes 2 No
V No Required: ❑Yes No ❑ be required based on final location and elevations of facilities
Type of Water Supply: El Community MPublic ❑ Well Distance from well feet Permit valid for. bd'F ,,~~~ive years
Permit conditions:
❑ No expiration
Authorized State Agent: Date: 2Gf SEE ATTACHED SITE SKETCH
The issuance of this permit by ealth Department in no way guarantees the issuance of other 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, .1951, .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 T0:
It
G14
PROPERTY LOCATION: vl qz
SUBDIVISION err M c cEe e LOT #
Facility Type: S`~ D tZ New ❑ Expansion ❑ Repair
Basement? ❑ Yes No Basement Fixtu es? ❑ Y ❑ No
Type of Wastewater System** C ife,47 Cel (Initial) Wastewater Flow: GPD
(See note below, if applicable
Cts`t0'e'1(- r ue,- (Repair)
Installation Requirements/Conditions Number of trenches
Septic Tank Size _600 _ gallons Exact length of each trench feet
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of: 16 ;,70 inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
Pump Requirements: ft. TDH vs. _ GPM
..mot cf M-J :4- 1,,,Y'4- 0
Trench Spacing: 9 Feet on Center
Soil Cover: _/Inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
inches below pipe
Aggregate Depth: inches above pipe
f inches total
**If applicable: / understand the .system type rpeci6ed is different from the type specified on the app/ication. / accept the ,rpecificatiofls of this permit.
Owner/Legal Representative Signature: Date:
Thu Construction Authorization is subject to revocation if the site 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 subject to 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: f d Dater
` Construction Authorization Expiration Date: IC 2G.E
HTE# _Z o J 8CR
Permit # ~Z_ k. (18
Harnett County Department of MiMic nealth
Site Sketch
PROPERTY LOCATON:
Gtd
ISSUED T0:
SUBDIVISION
t
` /camp LOT #
Authorized State Agent
9 X? 0.( o
Date: 1111
!
,
Department of Environment, Health and Natwld Resmurces
Division of Environmental Health Sheet:
On-Site Wastewater Section Property ID:
Lot a:
SOIUSITZ EVALUATION File 0:
for ON-SIT& WA.ST16WATL'& Sy3TM Code:
Owner. Applicant:
Addn= Date
Pr0pow Facalih: Deslg>f Ftow (.1949Y Property Size -
water of Situ Property E~rded:
WSupply; he ❑ Indivi" ❑ Well
❑ Spring
Evaluadou Meth rAuga Boring ❑ Pit . Cut
Type of wastewater age ❑ Industrial Pmcem Mixed
P
it
O
F
1
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.1940
.1941
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.1941
1941
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GTM
PRO FAC
.1-942
s~ x.1043
Waft" s..u
Site C1awcatlon (,1948), f
Othara Prey
❑ Other
.1916 .194
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orris
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