IP R-OnlyHTE# 1 Harnett County Department of Public Health
Imurovement Permit 26381
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: 0 L-o 05 a,l
ISSUED TO: Uy Le )Ao Go 6 SUBDIVISION LOT #
NEW,, REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance: (Type of Structure: G-+fn, n11-1 VvaQO-5E. {40.cl ' S~yssbr P.nE,a.cCQ RE G.$Pi?~0 ~NO (;y;5 1' F- w\ tc6D
Proposed Wastewater System Type: PciCSSUCtE, MP~tv~rbT-~ 5~5~6r<,
Projected Daily Flow: a~'tet5 GPD Go.~RUG~\o~ P2,~~+as w' t)TLD1N~ CAPL`T`l
Number of bedrooms: Number of Occupants: 59c} max
Basement ❑Yes ~No
Pump Required~Yes ❑ No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community "X Public El Well Distance from well GOO feet Permit valid for: Five years
Permit conditions: ❑ No expiration
Authorized State Agent:: ~ E~~S Date: ti1`7I 11 SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantee the i % nce of other permits. The permit holder is esponsible 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 Im pvement 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, .1951, .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:
Facility Type:
Basement? ❑ Yes ❑ No
Type of Wastewater System** _
(See note below, if applicable
(Repair)
Installation Requirements/Conditions Number of trenches
Septic Tank Size 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
Conditions:
inches below pipe
Aggregate Depth: inches above pipe
inches total
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.
**If applicable: /understand the system type specified is different from the type specified on the application. / accept the svecilcationr of this permit.
Owner/Legal Representative Signature: Date:
This Construction Authorization is subiect 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
Construction Authorization is subject to compliance with the provisions 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:
Construction Authorization Expiration Date:
PROPERTY LOCATION:
SUBDIVISION
❑ New ❑ Expansion ❑
Basement Fixtures? ❑ Yes ❑ No
Repair
(Initial) Wastewater Flow: GPD
LOT #
feet Trench Spacing: Feet on Center
Soil Cover: inches
inches (Maximum soil cover shall not exceed
36" above the trench bottom)