IPAC RHTE # 5- L4a4►'9(1arnett County Department of Public Health 29868
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: F'jA1a£�2AS
ISSUED T0: -FOOdO 1401140 -MO SUBDIVISION LOT #
NEW REPAIR ❑ EXPANSION ❑
Type of Structure: y62 5 4 a 7` 4 -4J
Proposed Wastewater System Tyype: 'a5%v A tz. 44 (0/l S,J.
Projected Daily Flow: Z/tvU GPD
Number of bedrooms: Number of Occupants: `6 max
B ❑Y
Site Improvements required prior to Construction Authorization Issuance:
asement es o ��
Pump Required: ❑Yes ❑ No�aC+�'M y ired based on final location and elevations of Facilities
Type of Water Supply: El Community L'I�Public ❑ Well Distance from well NA- Feet
Permit conditions:
Permit valid for:
of
❑ No expiration
Authorized State Agent: Z�- 4,/� �/ Date: C- U - / a&/!B 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 (or the king 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 Permjtj
The construction and installation requirements of Rules .1958, .1952, .1954, .1955, .1956, .1957, .1958. and .1959 are incorporated by references into this permit and shall he met. Systems shall be installed in accordance
with the attached system layout.
ISSUED T0: S o oaten- "1 Til +-4O mA3 PROPERTY LOCATION:, t'Vi k l c ( I X30
SUBDIVISION LOT # a
Facility Type: Z 2 6-q '44' 2 --New ❑ Expansion ❑ Repair
Basement? ❑ Yes LIEF o Basement Fixtures? ❑ Yes ❑ No
Type of Wastewater System** ; 510 /L'e-AS3C-4 2 5 , 5 4Er- (Initial) Wastewater Flow: V166 GPD
(See note below, if applicable ❑)
alSYo fL¢J 5y5- (Repair)
Installation Requirements/Conditions Number of trenches 8
Septic Tank Size I a SO gallons Exact length of each trench 6 O feet Trench Spacing: y Feet on Center
Pump Tank Size gallons Trenches shall be installed on contour at a Soil Cover. G inches
Maximum Trench Depth of: / 9J— inches (Maximum soil cover shall not exceed
(Trench bottoms shall be level to +/_I/4" 36" above the trench bottom)
in all directions)
Pump Requirements: ft. TDH vs. GPM r..St"' inches below pipe
Aggregate Depth: inches above pipe
Conditions: t>r-2x5[ inches total
v
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 specAed is different from the type speciled on the application. / accept the specilcationr of this permit.
Owner/Legal Representative Signature: Date:
This Construction Authorization is subject to revocation if the site plan, plar, or the intended use changes. The Construction Authorization shall not be transferred when there is a change in ownership of the site. This
amtuctmn Authorization IS sugect to compliance with the provisions of the Laws and Rules (or Sewage Treatment and Disposal and to the conditions of this permit. SEE ATTACHED SITE SKETCH
Authorized State Agent: -r!- /� �`/�G2 Date -
/l I dot Cb
e�v 22 gi,J Construction Authorization Expiration Date:
valval aoA3
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HTE# I-5 -4a 71 ail Permit # F ate
Harnett County Department of Public Health
Site Sketch
PROPERTY LOCATON:,1Xq 2—AC- (5 . C��)
ISSUED TO: !J-M� SUBDIVISION LOT # G?
Authorized State Agent: �� �- _ _ ��' Date: 9H�
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