IPACHarnett County Department of Public Health 29675
hDrovement Permit
A building permit cannot be issued with only an Improvement Permit
('� PROPERTY LOCATION: 1,5D �Aor,ow, C.xq.GL.E
ISSUED TO: 4 IQ el l tm—%0N SUBDIVISION LOT #
NEW ❑ REPAIR ❑ NSIONX Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: —I" 100 Q-367-76
Proposed Wastewater System Typpe: LEttv`fC>a�10-N V, L,.,
Projected Daily Flow: 3 LO GPD
Number of bedrooms: 3 Number of Occupants: C max
Basement []Yes 'Wo
Pump Required: ❑Yes ,15no ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community Public ❑ Well Distance from well feet Permit valid for. XFive years
Permit conditions: ❑ No expiation
Authorized State Agent: 7N� QG.HS Date: _ 7 1 igI rl SEE ATTACHED SITE SKETCH
The issuance of this permit by she Health Department in no way guarantees the issua. The permit holder is res nsible for checking with appropriate governing bodies in meeting their requirements. This
site is subject to revocation if the 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 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, .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 systemlayout
ISSUED TO: pct;' oN's PROPERTY LOCATION: _'So 1 0rznria C., ac a_6.
SUBDIVISION LOT #
Facility Type: MCS0 L36 "� �� ❑ New 'X Expansion ❑ Repair
Basement? ❑ Yes > No Basement Fixtures? ❑ Yes '15k No
Type of Wastewater System" C-oc�aV CG -f4�5 u N Cy,z., (Initial) Wastewater Flow: 33: b GPD
(See note below, if applicable ❑)
0"5616
REot l( R V.,r Sy 5 (Repair)
Installation Requirements/Conditions
Number of trenches 11.
Septic Tank Size •—J" G gallons
Exact length of each trench "l feet
Pump Tank Size gallons
Trenches shall be installed on contour at a
Maximum Trench Depth of: t a inches
(Trench bottoms shall be level to +/.I/4"
in all directions)
Pump Requirements: (t. TDM vs.
GPM
Conditions: lli�toc 1 "7 O
Q— aG
Trench Spacing: 'i�l Feet on Center
Soil Cover: T—Inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
Aggregate Depth:
i o Etn r A IN air"Itn
WATER LINES (INCLUDING IRRIGATION) MUST BE LOFT. 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: / underhand the tyttem type tpecihed a different fmm the type tpecihed on the application. / accept the spec/ffcadont of this permit.
Owner/Legal
Date:
hms cumurucuon numonzaron is rerowuoit it 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 Authonzationisplijec to compliance w Bhissl the laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent:
Date: —7 11911-1
Authorization Expiration Date:
HTE# 1 5 -Ll 1-7-1 G Permit # aCl
Harnett County Department of Public Health
Site Sketch
PROPERTY LO(ATON:_ 150 Dow "orm am CQxxG
ISSUED TO: �o o2Too1 /SUBDIVISION
Authorized State Agent: ,t �i5 �gLaCa SroLYsaosS Date: �� X91»
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