IPACHTE# 06-50o15 7 Harltctt County Department of Public rrcalth 23384
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION:
ISSUED TO: Y 1 `✓ rc �f—s °�z 2 S SUBDIVISION `J Ln r 3 I �/• I) S LOT #
NEW,O REPAIR 11EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: ,S F n `fJ X le n3[j 2
Proposed Wastewater System Type: r9 f °/ / [C1 c < ;'-
Projected Daily Flow: 3 bJ GPD
Number of bedrooms:_ Number of Occupants: 4M._ (max
Basement []Yes 21 No
Pump Required: ❑Yes ❑ No IZ] May be required based on final location and elevations of facilities ��y
Type of Water Supply: ❑ Community W ublic 11 Well Distance from well -S-0 feet Permit valid for. AJ Five years
Permit conditions: Cc% 0nJric 4, r1a I 4A j ❑ No expiration
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Authorized State Agent: 1 Date: �' S J L SEE ATTACHED SITE SKETCH
The issuance of this permit by the ealth 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 ect 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
Reauired for Buildine Permit
The construction and installation requirements of Rules .1950, .1952, .19S4, .1955, .19S6, .1951, .1958. and .1959 are incorporated by references into this permit and shall be met. Systems shall be
installed in accoa with a atrash yscem gout.
ISSUED T0: in) PROPERTY LOCATION: IIS L
SUBDIVISION )/ fly LOT # -J'L
facility Type: itJ>t (of &L New ❑ Expansion ❑ Repair
Basement? ❑ Yes '% No Basement Fixtures? ❑ Yes ;d No
Type of Wastewater System" 354- i4cl ct,., Suj-kj-� (Initial) Wastewater Flow: GPD
(See note below, if applicable ❑) /�
LIP(4knnwti 363 tr (Repair)
Installation Requirements/Conditions
Septic Tank Size 130 gallons Exact length of each trench lX 2 2) feet Trench Spacing: Feet on Center
Pump Tank Size gallons Trenches shall be installed on contour at a Soil Cover. inches
Maximum Trench Depth of: _1J 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: ft. TON vs. GPM
Conditions:
inches below pipe
Aggregate Depth: inches above pipe
inches total
**If applicable: / understand the tyctem type spealed it different from the type rpealed on the application. / accept the fpedfrcationd of thin permit
Owner/Legal Representative Signature: Date:
This Construction Authorization is subject to revocation if the site plan, plat, or the intended use changes. The (instruction Authorization shall not be transferred when there is a change in ownership
of the site. This Construction Autho n 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: I Date: I �'
Construction Authorization Expiration Date:1' -01 it
12
HTE# 06'P" ( S—SS7 Permit # J33 21Z
Harriett C'onnty Department of Public Health
Site ."ketch
nn \ PROPERTY LOCATON: I I I
ISSUED TO: V c z S SUBDIVISION 00bV7, 'Alls C LOT # �3 7
A Ithorized State Agent Date: J� 5, 0
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