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Harnett County Department of Public Health 29288
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: "It <u-4 KSI. Cis c4"s��
ISSUED T0: (Lo\otrt- An n o n -2 r c L—C,- SUBDIVISION LOT #
NEW E/ REPAIR ❑ EXPANSION ❑
Type of Structure: 5 6 (L__ S P O
Proposed Wastewater System Type: Z6% 1z A, A-,:cn S; SFc
Projected Daily Flow: �o O GPD
Number of bedrooms: S Number of Occupants: / 6 max
Basement L1es ❑ No
Site Improvements required prior to Construction Authorization Issuance:
Pump Required: CWs ❑ No ❑May e required based on final location and elevations of facilities
Type of Water Supply: ❑ Community f�blic ❑ Well Distance from well feet Permit valid for. live years
Permit conditions: r ❑ No expiration
Authorized State Agent: Date: /o7/0/'o l7-- 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 it 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 in compliance with the provisions of
the laws and Rules for Sewage Treatment and Disposal and to conditions of this permit.
Construction Authorization
Reouired 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: (Zo 6 rr An n u n Z-' c4k PROPERTY LOCATION: /oy9 Qr // ird GZd_ $ 2 I U 3 4)
SUBDIVISION LOT #
Facility Type: (570f ew ElExpansion 11 Repair
Basement? Yes El No Basement Fixtures? L yes ❑ No
Type of Wastewater System** Z 5 io lj et\ Q u A, Sys /-e'l ( Pvm (Initial) Wastewater Flow: 6 y o GPD
(See note below, if applicable ❑)
25��1(A.acAq,A SOk.A �P-"A0 (Repair)
Installation Requirements/Conditions Number of trenches `{
Septic Tank Size /Z60 + gallons Exact length of each trench /50 feet
Pump Tank Size f Z 5 0 -9 gallons Trenches shall be installed on contour at a
Maximum Trench Depth of:ll inches
(Trench bottoms shall be level to +/•I/4"
in all directions)
Pump Requirements: h. TDM vs. GPM
Conditions:
Trench Spacing: `7 Feet on Center
Soil Cover: -1e4R inches
(Maximum soil cover shall not exceed
36' above the trench bottom)
Aggregate Depth:
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: / ondeatand the system type specified is different from the type specified on the application / accept the specifications of this petzoth
Owner/Legal Representative Signature: Date:
This construction Authorization is subject 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 Authomation is
with the provisions of the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit. SEE ATTACHED SITE SKETCH
tho ized State ent: � c _.<�!i Date: S f US ) ac>v4
asps �ti Construction Authorization Expiration Date: S a I o1 );3cQ';
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HTE# `/O Z 8 J- Permit # Z `? Z $ T
Harnett County Department of Public Health
Site Sketch
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PROPERTY LOEATON: t o99 s (Z 14 3 --q,
ISSUED TO: `R 06cc--" ACIMvtl-CAC,_ SUBDIVISION LOT #
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