IPAC RHTE# /o -,5~'° 9.Y.37 , Harnett County Department of Public Hean 25994
Improvement Permit
A building permit cannot be issued with only an provementtPeit
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PROPERTY LOCATI r
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ISSUED TO•,
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SUBDIVISION $ °f ~R :Ft-
LOT # A
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REPAIR ❑
r r EXPANSION ❑
Site Improvements required prior to Construction Authorization Issuance:
Type of Structure:
Proposed Wastewater System T pe:
~Zr e cs e"w~ ~ttit'
t Cep`
Projected Daily Flow:
3
GPD
Number of bedrooms:
..3
Number of Occupants:
max
Basement ❑Yes
011lo
Pump Required: ❑Yes
21o
❑ May be required based on
final location and elevations of facilities
Type of Water Supply:
❑ Community blic ❑ Well
Distance from well feet Permit valid for:
ET ve years
Permit conditions:
❑ No expiration
Authorized State Agent:: 'qv Date: C e!~ s -Cwc /1 /actl SEE ATTACHED SITE SKETCH
The issuance of this permit by a Health Department in o 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, .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: u= ~ K PROPERTY LOCATI N: A` .
SUBDIVISION o.~ i o: -~tl ~1 LOT # l~
Facility Type: ENew ❑ Expansions ❑ Repair
Basement? ❑ Yes ❑ No Basement Fixtures? ❑ Yes ❑ No
Type of Wastewater System** RS ~ ~4e -r!4!CS (Initial) Wastewater Flow: GPD
(See note below, if applicable
A (Repair)
Installation Requirements/Conditions Number of trenches
Septic Tank Size 1060 gallons Exact length of each trench 4579
Pump Tank Size gallons Trenches shall be installed on contour at a
0
Maximum Trench Depth of:
(Trench bottoms shall be level to +/-1/4"
in all directions)
Pump Requirements: g t / ft. TDH vs. GPM
Con It10 s: / f~ C1T- 1-4," ' C"'I v."- a .L i~ csa~ G9 { *r^
feet Trench Spacing: ! Feet on Center
Soil Cover: inches
inches (Maximum soil cover shall not exceed
36" above the trench bottom)
inches below pipe
Aggregate Depth: inches above pipe
inches total
**If applicable: /understand the system type specifed is different from the type specified on the application. / accept the specifIcationr of this permit.
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 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 c Date:
1-9-
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Construction Authorization Expiration Date:
612
A,0103
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HTE# 2y 2 ? C A Permit # f q ~ V
Harnett County Department of 'nblic Health
Site Sketch
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