IPAC RNTE# (�"s- y +b2 Harnett County Department of Public Health 29880
Imurovement Permit
A building permit cannot be issued with only an Improvement Permit s� ��� `(
CS ���"W� PROPERTY LOCATION: €55 Sorsic -r 6we, Ln . CGla s rux, S �
ISSUED TO: :�%v pc �� SUBDIVISION 2:v>�c��� YC3 Es�� LOT # QQ
NEW f�� REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: _362 3r61 Y SC I twoSi7
Proposed Wastewater System Type: 95K>
Projected Daily Flow: C' C' GPD
Number of bedrooms: Number of Occupants: G max
Basement Dyes 2+0—
Pump
oPump Required: ❑Yes ❑ NdaL�'M y be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community f� ❑ Well Distance from well ^—o— feet Permit valid for. affive years
Permit conditions: ❑ No expiration
Authorized State Agent: o i i4!� Date: c�Q/ aol Oc j 9,, 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 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
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ISSUED TO: ♦Erb. �� PoS��17 PROPERTY LOCATION: �`� S(atsKes L°c- Gn. &1d. Sbyc2� 5�
SUBDIVISION t(LLOT # �?$
Facility Type: 3fjrL aCh`xsc a nAr-t- � ❑ Expansion ❑ Repair
Basement? ❑ Yes o Basement Fixtures? ❑ Yes ❑ No
Type of Wastewater System** 23 b `/o N is.,CJc Sss (Initial) Wastewater Flow: 3C c> GPD
(See note below, if applicable ❑)
Q-E-(-C2aAjZaS,& lY r 1. Sts (Repair)
Installation Requirements/Conditions Number of trenches 3
Septic Tank Size t S:> C --C> gallons Exact length of each trench t OG feet Trench Spacing: Feet on Center
Pump Tank Size gallons Trenches shall be installed on contour at a Soil Cover. inches (irv%PprL«y�
Maximum Trench Depth of L a 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: (t. TON vs. GPM t mA inches below pipe
_ Aggregate Depth: N it inches above pipe
Conditions: iii, -& SePkiArc
inches total
WATER LINES (INCLUDING IRRIGATION) MUST BE ]OFT. FROM ANY PART OF SEPTI( SYSTEM OR REPAIR AREA.
NO UTILITIES ALLOWED IN INITIAL OR REPAIR DRAIN FIELD AREA.
**If applicable: / undeataad the grtem type rpeciled it different from the type Jperiled 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, plat or the intended use changes. The construction Authorization shall not be transferred when there is a change in ownership of the site. This
constmctian Authorization is mbfect 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: - i " Date: a9 / ao/ aot g
Construction Authorization Expiration Date: C --a2100 / o;093
HTE# i ' S'" a y102 Permit # a cf bEso
Harnett County Department of Public Health
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ISSUED TO: Ke` 4--S" PaSSwc�
Authorized State Agent:
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Site Sketch
PROPERTY LO(ATON: 5r Act Ler_ /4). 5k2LaA- 5-
SUBDIVISION �•.we_rt�.r� t -bK- +>� LOT #�-
Date:
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