IPACHTE# I- S yayoy Harnett County Department of Public Health 29451
hDrovement Permit
A building permit cannot be issued with only an Improvement Permit
coy •I r.rLl PROPERTY LOCATION: 7-5() yAr,Lc,mb L-Ld (,5(L Z -003J
ISSUED TO: Pe_nri4 L.J- -4(-SUBDIVISION LOT#
NEW ❑ REP R ❑ EXPANSION Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: ev oa&5ea ln(3!L 5c --y> ( Exp ZB[z�
Proposed Wastewater System Type: Z5io tt 6. _Air, : a44a, v
Projected Daily Flow: 3&0 GPD
Number of bedrooms: 3 Number of Occupants: G max
Basement []Yes fro
Pump Required: Dyes ❑ No f�tay be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community 2'�`Fublic ❑ Well Distance from well too + feet Permit valid for.
Permit conditions:
f�n
❑ No expiration
Authorized State Agent: Date: 6 a-1 / 04 71 4— SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the issuance of other permit. The permit holder is responsible for thecking 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 pmvisions of
the tam and Rules for Sewage Treatment and Disposal and to conditions of this permit..
Construction Authorization
(Required for Building Permit)
The construction and installation requirement of Rules .1950, .1953, .1954, .1955, .1956, .1957, .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 TO: 'PEnMz Q Rlro it rxe p PROPERTY LOCATION: v60 Phlctur 10 " ( S (L Zc�n3)
SUB ISION LOT #
Facility Type: Qru 36 t' EY;oh. 26¢) El New Expansion ❑ Repair
Basement? ❑ Yes No Basement Fixtures? ❑ Yes ❑ No
Type of Wastewater System** EY -6� cl, Lc, nvLnk1QA&_\ -5 7s Ec at (Initial) Wastewater flow: 36a GPD
(See note below, if applicable ❑) J
, 5 7 s 16-1 (Repair)
Installation Requirements/Conditions Number of trenches 4
Septic Tank Size I cxoa gallons Exact length of each trench -45 feet Trench Spacing: c Feet on Center
Pump Tank Size gallons Trenches shall be installed on contour at a Soil (over: inches
Maximum Trench Depth oL• I Z inches (Maximum soil cover shall not exceed J
(Trench bottoms shall be level to +/-1/4" 36" above the trench bottom)
in all directions)
Pump Requirements: h. TDM vs. GPM
Conditions:
inches below pipe
Aggregate Depth: z, inches above pipe
Z_ inches total
WATER LINES (IN(LUDING IRRIGATION) MUST BE IOFT. FROM ANY PART OF SEPTIC SYSTEM OR REPAIR AREA.
NO UTILITIES ALLOWED IN INITIAL OR REPAIR DRAIN FIELD AREA.
**If applicable• / underhand the tyttem type tpeahed it different from the type tpecihed on the app/kation. / accept the rpeciGeationr of this permit
Owner/Legal Representative Signature: Date:
This construction Authorization is subject to revocation if the site pian, plat or the intended use changes. The construction Authorization shall not be conferred 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� Date: Ott J 0'-1 , T
Construction Authorization Expiration Date: C)LI to LIZZZ
NTE# 1 i- S q0508 Permit # 2 y y 51
Harnett County Department of Public Health
Site Sketch
o' PROPERTY LOCATON: Z -SU M,-L.c„r"oo a� 2
. ($ L�G3�
ISSUED T0: �5 M� 1J. Ore �'.11a� c� SUBDIVISION LOT #
Authorized State Agent ' `���.. Cil-^"'��� Date: O LI ) or-(/ z c,t j--
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