IPAC RHTE# 16-5—Lkc)OS1 Q, Harn,-. County Department of Public ...alth 29117
Improvement Permit
A building permit cannot be issued with only an Improvement Perrot
(\��� PROPERTY LOCATION: BoNo LN �NGTI�
ISSUED TO: I�Os�So.t_O l ]Offs% SUBDIVISION LOT#
NEW -D< REPAIR ❑ NSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: S esp k--�'O � 1A d_
Proposed Wastewater System Type: v "we
Projected Daily Flow: fi=t 3t -'%PD
Number of bedrooms: _� Number of Occupants: max
Basement 'IRfes ❑ No
Pump Required: []Yes; ❑ No May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Cammuniry Public 11� Well Distance from well S feet
Permit conditions: _
Permit valid for five years
❑ o expiration
Authorized State Agent: "ol�5 Date: �y 118 I / b SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees thea r�u hher permits, The permit holde is responsible for checking with appropriate governing bodies in meeting their requirements. This
site n subject to revocation if the site plan, plat, or the intended use changes. Th romment lr In 11 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 perms .
y.7 R6v w5 hJ 5� a�� 71
Construction Authorization
(Required for Building Permit)
The construction and installation requirements of Rules .1950, .1952, .1954, .1955, .1956, .1957, .1958. and AM arc incorporated by references into this permit and shall be met Systems shall be installed in accordance
with the attached system layout ,p `
ISSUED TO: l�o c s oa O �^d�a fl PROPERTY LOCATION: �J� s s D
SF L30hkOJ SUBDIVISION LOT #
Facility Type: 9 New ❑ Expansion ❑ Repair 3LQ
Basement? ❑ Yes No Basement fixtures? ❑ Yes �V No
Type of Wastewater System** ZSe � d QG0uL: 1 t) lJ � 1>>E -an P„he (Initial) Wastewater Flow: �_ GPD
(See note below, if applicable ❑)
P\,aMf Q Q -9`/c, REQ- (Repair) \W
Installation Requirements/Conditions Number of trenches 1
Septic Tank Size 10 o cD gallons Exact length of each trent feet Trench Spacing: Feet on Center
Pump Tank Size a00 d gallons Trenches shall be installed on contour at a Soil Cover. S'k inches
Maximum Trench Depth of:' 30'rl 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: (L TDM vs. GPM inches below pipe
Aggregate Depth: inches above pipe
Conditions:
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.
inches total
**If applicable: / understand the system type spedled /s different from the type spelled on the applinden. / accept the rpecifiartionr of permit
Date:
This Construction Auction on o subject to t she m Ian, plat, or the intended use changes. The Construction Authorization shill not be transferred when there is a change in ownership of the site. This
construction Authnnzation is c compliance wi " �on a Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Date: I T JJtS 116
s) ls) s7 Coon tnt tQ' n Authorization Expiration Date:
HTE# 1 6- 5- 006 �,Q- Permit # a°I t l -I
Harnett ('onnt%- Department of Public Health
Site Sketch
ISSUED TO:
Authorized 1
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LOT #
Date: ll' W116
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