IPACHTE# 16-55-tJCD lGS Harnett County Department of Public Health 29136
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
ISSUED T0:ym-C�a-1-
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N„�a ` �rs,� ,O SUBDIVISION _�VTC2yy cx,Fs
LOT # 1
NEW ❑
REPAIR ❑
EXPANSION Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: - 4010k
0'4n)J��
Proposed Wastewater System Type:
�eiA
ci w.ri kion 104 5,'siG-N)
Projected Daily Flow:
s+J
GPD
Number of bedrooms:
4
Number of Occupants: '2 max
Basement ❑Yes 'K No
Pump Required: Dyes
''MNo
❑ May be required based on final location and elevations of facilities
Type of Water Supply:
❑ Community �R Public ❑ Well Distance from well feet
Permit valid for. Five years
Permit conditions:
❑ No expiration
Authorized State Agent:: 9-r\,,Date: 1 � X31 I3 SEE ATTACHED SITE SKETCH
The iswanre of this permit by the Health Department in no way guarantees the a of other permits. The permit holder is responsible for checking with appropriate governing bodies in meeting their requirements. This
site is subject m revocation if the site plan, plat or the intended use changes. The Imps mens 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
Reauired for Building Permit
The anstmction and installation requirements of Rules .1958, .1951, .1954, .1955, .1956, .1957, .1958. and .1959 are incorporated by references inm this permit and shall be met Systems shall be installed in Korduce
with the attached system layout
ISSUED TO: pQc1,e-cR-+d PROPERTY LOCATION: Wat1E ��
SUBDIVISION pxvz2y INCAIC5 LOT # i
Facility Type: 0 w n H ❑ New X, Expansion ❑ Repair
Basement? ❑ Yes 't3c No Basement Fixtures? ❑ Yes XNo
Type of Wastewater System** ca -Si ry RC -OV c:7, u #,S S S iL (Initial) Wastewater Flow: GPD
(See note below, if applicable ❑)
T Q in f—,7^a�� • '9' - • (Repair)
Installation Requirements/Conditions Number of trenches '1
Septic Tank Size Ex sz a N (, gallons Exact length of each trench 7 5 feet Trench Spacing: Feet on Center
Pump Tank Size gallons Trenches shall be installed on contour at a Soil Cover: 6 inches
Maximum Trench Depth of: S1- s% inches (Maximum soil cover shall not exceed
(Trench bottoms shall be level to +/-1/4" 36" above the trench bottom)
in all directions)
Pump Requirements: ft. TDM vs. GPM inches below pipe
Aggregate Depth: inches above pipe
Conditions: Use �L laaa.v inches total
TovCt. Ler- Es.
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.
It applicable: /understand the system type sperifred is different from the type specified on the application. / accept the speuf'ranizas of this permit
Owner/Legal Rep eLtative Signature: Date
Thu Construction Authorization is su fe anon 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 tk§sot to camp lia m of the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent: RAN Date: 1 v s
Construction Authorization Expiration Date: L A�
HTE# L- -Ll )LI 65 Permit # a� )3 -4
Harnett County Department of Aiblic Health
Site Sketch
PROPERTY LOCATON: 410E
ISSUED T0: �vpc$u � O�J,O SUBDIVISION 1., -s LOT # 1
Authorized State Agent: ��y\ � 6L,t64 `M-f,5b%AT) Date: ! 1 )3 117
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