IPAC RHTE #J(, --S _171 Z Harnett County Department of Public Health 29400
Improvement Permit
A building permit cannot be issued with only an Improvement �Pe/rmit
An!—,
// PROPERTY LOCATIONcW—/V/ S 40.e -ra /�
ISSUED TO i>�Y� _�AT G SUBDIVISION LOT #
NEW REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure:—SF!,
Proposed Wastewater System Type:
Projected Daily Flow: 3 ks(=� GPD
Number of bedrooms: S Number f Occupants: max
Basement ❑Yes Ed No
Pump Required: ❑Yes ❑ No Ma a required based on final location and elevations of facilities
Type of Water Supply: ❑ Community Public ❑ Well Distance from well feet Permit valid for: O -Five years
Permit conditions: ❑ No expiration
Authorized StateJ&" Date: %—fie—/ ? SEE ATTACHED SITE SKETCH
The issuance of this permit b e A Department in no way guaranines she issuance of ocher permits. The permit holder is responsible for checking with appropriate governing bodies in meeting their requirements. This
site is subject to revocation i te sire 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 taws 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, .1952, .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 s
ISSUED TO: ZfoJ l ZO PROPERTY LOCATION: / VLA41—"� "i
�y\SUBDIVISION ✓ lSl����� _ LOT #
Facility Type: Q New��Expansion El Repair'
Basement? El Yes No Basement Fixtures? ❑ Yes L�'No �/
Type of Wastewater System** %ale/ s —�—�. 71 (Initial) Wastewater Flow: y� GPD
(See note below, if applicable ❑)
Conditions:
Trench Spacing: Feet on Center
Soil [over: inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
Aggregate Depth:
WATER LINES (INCLUDING IRRIGATION) MUST BE 10FT. FROM ANY PART OF SEPTIC SYSTEM OR REPAIR AREA.
NO UTILITIES ALLOWED IN INITIAL OR REPAIR DRAIN FIELD AREA.
inches below pipe
inches above pipe
_ inches total
**If applicable: / understand the system type specified is different from rhe type specified on the application. / accept the specifcationr 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
tunstmmon Aumoneanon IS subject to compliance with the provisions of the laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit M AI IALNLU NIL MILE!
Authorized State en Date: % L — ( %
[onstrucion Authorization Expiration Date: —7 - Z -p—
?,��zAn
__
(Repair)
Installation Requirements/Conditions
Number of trenches
3
Septic
Tank Sizegallons
Exact length of each
trench r) feet
Pump
Tank Size gallons
Trenches shall be installed on contour at a
Maximum Trench Depth oL•_ inches
(Trench bottoms shall
be level to +/.I/4"
in all directions)
Pump
Requirements: ft. TDM vs.
GPM
Conditions:
Trench Spacing: Feet on Center
Soil [over: inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
Aggregate Depth:
WATER LINES (INCLUDING IRRIGATION) MUST BE 10FT. FROM ANY PART OF SEPTIC SYSTEM OR REPAIR AREA.
NO UTILITIES ALLOWED IN INITIAL OR REPAIR DRAIN FIELD AREA.
inches below pipe
inches above pipe
_ inches total
**If applicable: / understand the system type specified is different from rhe type specified on the application. / accept the specifcationr 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
tunstmmon Aumoneanon IS subject to compliance with the provisions of the laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit M AI IALNLU NIL MILE!
Authorized State en Date: % L — ( %
[onstrucion Authorization Expiration Date: —7 - Z -p—
HTE# A�---3')1/ jj
Permit # Z77 Y D d
Harnett County Department of 11�iblic Health
Site Sketch
/ PROPERTY LOCATONEP—/q/ /CL
ISSUED TO: `,.%iG SUBDIVISION s, . LOT #
Authorized
Date:
J
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