IPACHTE# I1—5-4)'iCo Harnett County Department of Public Health 29549
ISSUED TO:
NEW ❑ REPAIR I—
Type of Structure:
Proposed Wastewater System Type:
Projected Daily Flow:
Number of bedrooms:
Basement ❑Yes
❑ No
Pump Required: []Yes
❑ No
Type of Water Supply:
❑ Community
Permit conditions:
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION:
SUBDIVISION LOT #
EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
_ GPD
Number of Occupants: max
❑ May be required based on final location and elevations of facilities
❑ Public ❑ Well Distance from well feet
Permit valid for:
❑ Five years
❑ No expiration
Authorized State Agent:: Date: SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the issuance of other permits. The permit holder is responsible for 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. 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 system layout
ISSUED TO: -14 %J,,4r'fn-dl a itf ic,"iQ4-,(31V av PROPERTY LOCATION: 1ZLS 9-AN69,10
Facility Type: GA'i - SFD
Basement? ❑ Yes ❑ No Basement Fixtures?
Type of Wastewater System'*
(See note below, if applicable ❑)
SUBDIVISION 'Soxang'5M si4 LOT # _
❑ New ❑ Expansion :K Repair
❑ Yes ❑ No
(Initial) Wastewater Flow: GPD
Installation Requirements/Conditions Number of trenches
Septic Tank Size 1 ooO gallons Exact length of each trench
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of:
(Trench bottoms shall be level to +/-1/4"
in all directions)
Pump Requirements: ft. TDH vs. GPM
feet Trench Spacing: Feet on Center
Soil Cover. inches
inches (Maximum soil cover shall not exceed
36" above the trench bottom)
�\ Aggregate Depth:
Conditions: �L—PLs�.cC psv� �ti0 0,ugeL-1 La, a� �s \\ll60
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 below pipe
inches above pipe
inches total
**If applicable: / onderstand the tynem type tpeu6ed it different from the type rperiled on the application. / aaept the spec 6tirdons of this permit.
Owner/Legal Representative Signature: Date:
This Construction Authonzza na to nivoadon 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 Authorlaprovisions of the Lawn and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent: `��� �� aC3r1S Date: 8
vection Authorization Expiration Date: