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IPAC RHTE# t6-5-3°r�a161 Harnett County Department of Public Health 29801 Imarovement Permit A building permit cannot be issued with only an_provement Permit a PROPERTY LOCATION: �l P.GX,50 zv Rq ISSUED TO- Cr! TOO- L PT-0N , �tNC-,i- or MPrty SUBDIVISION LOT # NEW L� REPAIR ❑ EXPANI J ❑ Site Improvements required prior to Construction Authorization Issuance: Type of Structure: 5'c C to o' x til Proposed Wastewater System Type: rdu0 o EO V L o N Y]^Eon Projected Daily Flow: GCS© GPD Number of bedrooms: b Number of Occupants: 10 max Basement Ayes ❑ No Pump Required: ❑Yes ❑ No X May be required based on final location and elevations of facilities Type of Water Supply: ❑ Community ❑ Public X Well Distance from well I o© feet Permit valid for. Five years Permit conditions: ❑ No expiration Authorized State Agent: QG Date: 118 0111 SEE ATTACHED SITE SKETCH The issuance of this permit by the Health Department in no way guarente hm of other permit. The permit holder is re !, le for chehing 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 in'llerevellIMPermit 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 .1958, .1957, .1954, .1955, .1956, .1957, .1958. and .1959 are incorporated by references into this permit and shall be mel. Systems shall be installed in accordance with the attached system layout ISSUED T0: —G L- AYTOcJ�i+G`r ?` IAA� PROPERTY LOCATION: J PGXS0n7 RD SUBDIVISION LOT # Facility Type: SF9 �LOo"J6�5�� New ❑ Expansion ❑ Repair Basement? '?S� Yes ❑ No Basement Fixtures? ),Yes ❑ No Type of Wastewater System" a.570 ReSw 6is0s SySi Ern (Initial) Wastewater Flow: GOO GPD (See note below, if applicable ❑) PV ^.+P el aSe/o 1- sl . SXS. (Repair) Installation Requirements/Conditions Number of trenches T Septic Tank Size ta570 gallons Exact length of each trench 560 feet Pump Tank Size gallons Trenches shall be installed on contour at a Maximum Trench Depth of: \S_ inches (Trench bottoms shall be level to +/-1/4" in all directions) Pump Requirements: h. TDH vs. GPM Conditions: V-Np*L— 1--P-70vS'T-�d $E �6SfsLrss�EA �; Trench Spacing: call Feet on Center Soil Cover. Co inches (Maximum soil cover shall not exceed 36" above the trench bottom) inches below pipe Aggregate Depth: inches above pipe 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. / understand the system type specified is different from the type specified on the app/iration. / accept the Jpetiftadonr of this permit. Owner/Legal Representative Signature: Date: This Construction Authorization is subject ro 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 tonstructhon Au homaton is subject to compliance with the provisions of the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit ltt AI IALHLO lilt IALILH Authorized State Agent 4 L–Date: \1 20 1 n truction Authorization Expiration Date: 1. 022 HTE# �(�' n3 1 6— Permit # Harnett County Department of Public Health Site Sketch PROPERTY LOCATON: JAc cso 6 ISSUED TO: N �SP�G�Z n� p SUBDIVISION LOT # I - Authorized State Agent: �_»� �6N{f�SD�� Date: l A1—I O Aly �� Eto A2 $A hUUs6