IPAC RRRHTE# t6- Harnett County Department of Public Health 29547
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: g ums RD
ISSUED TO: 21667 A LtrL6.t s G `hro.E., SUBDIVISION LOT At
NEW ❑ REPAIR ❑ EXPANSION )K
Type of Structure: WEooaev ( YEK t.,L
Proposed Wastewater System Type: 96S°/9 5yzs,% n
Projected Daily Flow: 00 GPD
Number of bedrooms: Number of Occupants: 1 a•a max
Basement ❑Yes )<No
Pump Required: []Yes 4�oo ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community XPublic ❑ Well Distance from well feet
Permit Conditions: W o F -o co 96.Le ll, S3 u5 t.olw C.
Site Improvements required prior to Construction Authorization Issuance:
Permit valid for.
Nwe years
o expiration
Authorized State Agent: T15 Date: 4 )5 T❑ SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guars uanco of other permits. The permit holder is responsi k far checking with appropriate governing bodies in meeting their requirements. This
site is subject to revocation if the site plan, plat or the intended use changes. Yemeni Permit shall not be affected by a change in ownership o1 the site. This permit is subject to compliance with the provisions o1
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, .1953, .1954, .1955, .1956, .1957, .1958. and .1959 are incorporated by references into thin permit and shall be met. Systems shall be installed in accordance
with the attached system layout.
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ISSUED T0: Gra.T ccs F)—oa:�,a PROPERTY LOCATION: t,iSS RD
SUBDIVISION LOT #
Facility Type: \Av oyw% r c V Few u E. ❑ New ITExpansion ❑ Repair
Basement? ❑ Yes "51, No Basement Fixtures? ❑ Yes �kNo
Type of Wastewater System** a,5% qEOUG'S% a ,y S—)5 Z E-trN (Initial) Wastewater Flow: W O GPD
(See nate below, if applicable ❑)
pu. % 1 a C F "-46"Sx u rs:KI, (Repair)
Installation Requirements/Conditions Number of trenches 3
Septic Tank Size I a s0 gallons Exact length of each trench "T 5 feet Trench Spacing: 01 Feet on Center
Pump Tank Size gallons Trenches shall be installed on contour at a Soil Cover. C—Inches
Maximum Trench Depth of: 1% 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: ft. TDH vs. GPM inches below pipe
Aggregate Depth: inches above pipe
Conditions: rJ¢E S,�E S�ESGyx �orl— Co o�iay �5 inches total
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.
**If applicable: l nndeatand the smem type rpecifed is different from the type rpecihed on the application. l accept the specifcaaonr of this permit.
Owner/Legal Representative Signature: Date:
This Construction Audio �zation is subject to revoau.on 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 itublea [o co Q�ptmrisions of the laws and Rules for Sewage Treatment and Disposal and to the conditions of this Permit SEE ATTACHED SITE SKETCH
Authorized State Agent:
Date:
Authorization Expiration Date:
HTE# S 3'X)�LSPQQ Permit # 19"--)
Harnett County Department of Miblic Health
Site Sketch
PROPERTYLO(ATON: E> V-"
ISSUED TO: Coal LO(L N � ?)"Iro-P\ / SUBDIVISION LOT #
Authorized State Agent: r15 l9' \A EATOLY3�U Date: 1 l iS� T7
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