IPACHTE# 1�-s 433IG Harnett County Department of Public Health 29889
Imarovement Permit
A building permit cannot be issued with only an Improvement Permit
_ PROPERTY LOCATION:R,�. 5tt- 2514
ISSUED TOS=:�2.hQ_[T�� Ccan�cacOc� SUBDIVISION LOT# ci
NEW Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: _3152 955x5y1 5 FSS
Proposed Wastewater System Type: 0 69. 4-e-ex,A,j. ,
Projected Daily Flow: 3G 6 GPD
Number of bedrooms: _ Number of Occupants: max
Basement []Yes ❑ No
Pump Required: ❑Yes ❑ No I�be rreecited based on final location and elevations of facilities
Type of Water Supply: ❑ Community LYPii ❑ Well Distance from well rva- feet Permit valid for.
Permit conditions:
eve years
❑ No expiration
Authorized State Agent: �G«' —c.F�S Date: C12 % a g-1 amt e', 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
ISSUED T0: PROPERTY LOCATION: QIS1 S)rtec-,CF Sohnx,n 15110
3m2 51 x SUBDIVISION LOT #
Facility Type: Sy' ST=S> L"Newt ❑ Expansion ❑ Repair
Basement? ❑ Yes ❑ No Basement Fixtures? ❑ Yes ❑ No
Type of Wastewater System** ')-�' h v L rn (Initial) Wastewater Flow: 3Co GPD
(See note below, if applicable ❑) � , -Ch(W-U' 9 o C�
orcS�2 az'. \ULks: �i t� S -46. ReyalC)
G s� 1ca,,lsbt�
Installation Requirements/Conditions Number of trenches � tL
Septic Tank Size ICx`>O gallons Exact length of each trench � a -et Trench Spacing: �/ Feet on Center
Pump Tank Size gallons Trenches shall be installed on contour ata Soil Cover. S3 •— inches
Maximum Trench Depth of: QO 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. TDH vs. GPM t A inches below pipe
�j Aggregate Depth: 1,3F, inches above pipe
Conditions On (rd LY1t vcc,\ S( --r l��{ t�eit� � A inches total
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.
I( applicable: /understand the system type specified is different from the type spedfled on the app/icatioa / accept the speciAradoor of this permit.
Owner/Legal Representative Signature: Date:
This Construction Authorization is subject to revocation it the site plan, plat, or the intended use changes. The Construction Authorization shall not be transferred when there is a longe 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: ,�/ �� Date:y3�i5%aa/rd
A�v`xtr C>j afu S � Construction Authorization Expiration Date: 032 tola?o8a
HTE# - y-3316 Permit # � &a c%
Harnett County Department of Public Health
Site Sketch
PROPERTYLO(ATON: a 161 51xr%� Jc)AAi)O/j ( f5%�
ISSUED T0: c� I�- G�nocu� CCIA([ r SUBDIVISION LOT #
Authorized State Agent: C/ _���—T���60�10- -- Date:C .3 I,/r;?()/ e
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