IPAC RHTE# 1:1-5-4 14 982 Harnett County Department of Public Health 29250
Improve ent Permit
A building permit cannot be issued with only an Improvement Permit grz, M.�
PROPERTY LOCATION: yah tJC a P nd (c L. l irzsile 2a
ISSUED TO ,Inn C.v �y�: Inc SUBDIVISION err LOT# 5�
NEW v REPAIR ❑ EXPANSION ❑ Site ImproverneM required prior to Construction Authorization Issuance:
Type of Structure: 30, 2 C.v` X Ga a S
Proposed Wastewater System Type:5% /l�5
Projected Daily flow: 3G.ra, GPD
Number of bedrooms: 3 Number of Occupants: b max
Basement ❑Yes 2115
Pump Required: ❑Yes El -#r— ❑ May be rhe sired based on final location and elevations of facilities
Type of Water Supply: ❑ Community 19 ublic ❑ Well Distance from well feet Permit valid for. IvLy-F a years
Permit conditions: ❑ No expiration
Authorized State Agent: —2 Date: I o /.;o / 2,c�k-x 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 requirement of Rates .19SD, .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: 1yctin Cc, �� s� PROPERTY LOCATION: quo Aver Q"„A p� Sn su�-S
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SUBDIVISION 1J,< c P� LOT # ��
Facility Type: �{i2 Gotx moo` 3g7 2� ❑ Expansion ❑ Repair
Basement? ❑ Yes E;k o Basement Fixtures? ❑ Yes ❑ No
Type of Wastewater System** 2 6;i 2 X c,a C.�S g (Initial) Wastewater Flow: 3`o GPD
(See note below, if applicable ❑)
Ai -Cerwke= 7 bi 2 a S L.....a (Repair)
Installation Requirements/Conditions Number of trenches r 3
Septic Tank Size lOap gallons
Pump Tank Size gallons
Pump Requirements: ft. TDM vs.
(onditions:
Exact length of each trench STs feet
Trenches shall be installed on contour at a
Maximum Trench Depth of: 1-6 inches
(Trench bottoms shall be level to +/_I/4"
in all directions)
GPM
Trench Spacing: 9 Feet on (enter
Soil Cover. G inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
Aggregate Depth:
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.
'".4 inches below pipe
° A inches above pipe
^a A inches total
*I( applicable: /understand the rystem type rpecibed is diNerent lrom the type rpecibed on the app/icadoa / accept the specifcadonJ of this permit
Owner/Legal Representative Signature: Date:
This Constucfion Authorization is subject to revontion if the site plan, plat or the intended use changes. The contraction Authorization shall not be tramlerred when there is a change in ownership of the site. This
Construction immunization 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: M� Date: _ / � / 7
",-u— — Construction Authorization Expiration Date:
HTE# i�- 5-41y`�t32
Harnett County
Permit # a 9 -a 5O
Department of Public Health
Site Sketch
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PROPERTY LO(ATON:yao A%J. ry n&,, A D„^(CV KIS fGJ�
ISSUED TO: C c,ntt-r,"or� SUBDIVISION A.z LOT # SS
Authorized State Agent: Date: L C� 30/
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