IPAC RHTE# 16 -S --3-76f � /� Harnett County Department of Public Health 29374
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
/ / PROPERTY LOCATI /N Z9 c
ISSUEDGwJ�I Sd7n� SUBDIVISION Cej&4LOT #
NEW Ill REPAIR ❑ EXPANSION ❑ Site Improve ents required prior to Construction Authorization Issuance:
Type of Structure:
Proposed Wastewater
Projected Daily Flow:
Number of bedrooms:
Basement ❑Yes
Pump Required: file
Type of Water Supply:
Permit conditions:
GPD
Number of Occupants: max
w�clu
❑ No ❑ MMay°freguired based on final location and elevations of facilities
ElCommunity IAFPublic ❑ Well Distance from well feet Permit valid for.
Z Five years
❑ No expiration
Authorized State Ant: L Date: if - G / — (7 SEE ATTACHED SITE SKETCH
The issuance of this permiS&GRsl Department in no way guarantees the issuance of other person. The permit holder is responsible for checking with appropriate governing bodies in meeting their requirements. This
site is subject to revoaatii 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
Reauired for Buildine Permit
The construction and installation requirements of Rules .1954 .1952, .1954, .1955, .1956, .1957, ASS. 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: -JJ -I-) �-)<r4c/1 PROPERTY LOCATI I: /t%LS LOT /2I.��
SUBDIVISION #
Facility Type: New ❑Mansion ❑ Repai
Basement? ❑ Yes Eer I{tr—, Basement Fixtures? ❑ Yes R116
Type of Wastewater System**
(See note below, if applicable
Installation Requirements/Conditions
Septic Tank SizeQQ gallons
Pump Tank Size O gallons
Pump Requirements: ft. TDH vs.
Conditions:
Number of trenches
Exact length of each trench bo 1 f-0 80 feet
Trenches shall be installed on contour at a
Maximum Trench Depth of: Inches
(Trench bottoms shall be level o /-1/4"
in all directions)
GPM
Flow: 36,z GPD
Trench Spacing: �` — 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
17 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: l anderuand the rrplem type specified it d1herent Gam the type spedfted on the application. l accept the precAcations of this permit
Owner/Legal Representative Signature: Date:
This 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 Treat nt and Disposal and to the conditions of this permit. SEE ATTACHED SITE SKETCH
Authorized State cat: e Date: (f— zi —/ 7
Construction Authorization Expiration Date: y-7-7— Z Z
HTE#%lo'J� 3�U /I X'— Permit #25 3 - y
Harnett County Department of Public Health
Site Sketch
ISSUED T0:
Authorized S
Date: '? ' 7i-7
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