IPAC RRRNTE# I q-5 -3 U -VQ42"arnett County Department of Public Health 29909
Improvement Permit
A building permit cannot be issued with onlya Improvement Permit
PROPERTY LOCATION: 505 5kecrzzc� Ps Ag?;s %D[-. LV s qi:--1 6-9
ISSUED TO: SUBDIVISION isW czvA:'CI P�%Aela LOT #
NEW REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: 49dL 6q ss. 4 .7' S
Proposed Wastewater System Ty e: ?SV C(.Q�u(3.,Ta(x
Projected Daily Flow: _b GPD
Number of bedrooms: � Number of Occupants: max
Basement ❑Yes L� Ro
Pump Required: ❑Yes ❑ No lay bye tuned based on final location and elevations of facilities �'
Type of Water Supply: ❑ Community LY Public ❑ Well Distance from well het Permit valid for. rv(�'f years
Permit conditions: ❑ No expiration
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Authorized State Agent:: Date: 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 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 instructions and installation requirements of Rules .1950, .1953, .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: lA PROPERTY LOCATION: aa6�1 6k43I7-iv'Cv-% PC n2S OcyS col s'�)
SUBDIVISION LOT #
Facility Type: 6CL- 59s X 94-? s b t�� p-lfew� ❑ Expansion ❑ Repair
Basement? ❑ Yes No Basement Fixtures? ❑ Yes ❑ No
Type of Wastewater System** a5yc" 52e.� x�kton 5 -L -.r>`. (Initial) Wastewater Flow: oc'tC� GPD
(See note below, if applicable ❑)
%v (1e-Av4Cton P('WS 5x5. (Repair)
Installation Requirements/Conditions Number of trenches 3
Septic Tank Size I a!SC-� gallons Exact length of each trench R C-) feet Trench Spacing: Feet on (enter
Pump Tank Size gallons Trenches shall be installed on contour at a Soil Cover: /`d--�> inches
Maximum Trench Depth of: 30-4116 inches (Maximum soil cover shall not exceed
(Trench bottoms shall be level to +/-1/4" 36" above the trench bottom)
in all directions)
Pump Requirements: h. TDH vs. GPM n inches below pipe
Aggregate Depth: N inches above pipe
(onditions:
inches total
WATER LINES (INCLUDING IRRIGATION) MUST BE )OFT. 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 speciled is different lom the type speuled on the application. / accept the specilcationr of this permit.
Owner/Legal Representative Signature: Date:
This Conswcuon 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 prowisions of the Laws and Rules for Sewage Treatment and Dispmal and to the conditions of this permit. SEE ATTACHED SITE SKETCH
Authorized State Agent: Date: 03/p��aolS
AbRvOrL a cw<c tr.z s� Construction Authorization Expiration Date: 03/0T if
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ISSUED TO:
5-3y5a9azz Permit # a c1 q0 c7
Harnett County Department of Public Health
Site Sketch
Authorized State Agent:
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