IPAC RRRHTE O �— S ''� I��/ �arnett County Department of Public Health 29163
hDrovement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION:2(1 S(e'S �5��✓� 3 �� >t P 3 /),A
ISSUED TO: S%/l/ I I / — -,c-- c- SUBDIVISION f4- — LOT # _37 -
NEW
-NEW E71' REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: _5P�
Proposed Wastewater System Type: 7s�f1�e{dLC Fz
Projected Daily Flow: 3 /a b GPD
Number of bedrooms: �: r� Number of Occupants: max
Basement ❑Yes LAS No ��
Pump Required: ❑Yes El No ZJMay be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community Id Public ❑ Well Distance from well feet Permit valid for. Olive years
Permit conditions: ❑ No expiration
Authorized Stat�ent, Date: I — 1 S -l-7 SEE ATTACHED SITE SKETCH
The issuance of this permitsy'VI alth 0eparbnent 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 revoatidn 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, .1953, .1954, .1955, .1956, .1957, .1956. and .1959 are incorporated by references into this permit and shall be met. Systems shall be installed to accordance
with the attached system layout
ISSUED TO�5 ' AT4—_ 1 /30r44.0 Esc, PROPERTY LOCATION:/L1'o
SUBDIVISION t4VIj Pis r_ LOT # 3%
Facility Type: [D_ New �pansion ❑ Repair
Basement? ❑ Yes d No Basement Fixture ? ❑ es No
Type of Wastewater System** 7��� a G� — (Initial) Wastewater Flow: 3 c- o GPD
(See note below, if applicable ❑
(Repair)
Installation Requirements/Conditions Number of trenches I q
Septic Tank Size f Dd 15 gallons Exact length of each trench 500 feet Trench Spacing: ! Feet on Center
Pump Tank Size gallons Trenches shall be installed on contour at a Soil Cover. _ inches
Maximum Trench Depth of: )6 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
Aggregate Depth:
Conditions:
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.
_C inches below pipe
Z inches above pipe
inches total
**If applicable: / understand the system type spetiled it different from the type spetiled on the app/motion. / accept the rperihtationJ of this permit.
Owner/legal Representative Signature: Date:
This construction Authorization u subject to revocation if the site plan, plat or the intended use changes. The construction Authorization shall not be transferred when there u a change in ownership of the site. This
LonsWmmn Authonaabon is subject to compliance with the provisions of the Laws and
Rules for Sewage Treatment and Disposal and to the conditions of this permit act AI IALMLU Nit MCRn
Authorized StaEEAgent=� �� Date: 1 - 13 -1 i
[_�— Construction Authorization Expiration Date: J- 13 - zZ
HTE# 07- S- 1 (� )(,L{ �-zZ Permit # �P// (e 3
Harnett County Department of Public Health
Site Sketch
C'.2� PROPERTY LO(ATON: S Z)
ISSUED TO: ` Y IN� �ur (c� 1,�G SUBDIVISION LOT #
Authorized State Agent_--,, --} i Date: 1-13 —
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