IPAC RHTE# Id -5-439 Harnett County Department of Public Health 29929
Improvement Permit
A building permit cannot be issued with only an Improvement Permit \
0p PROPERTY LOCATION: S3V i�o� Lcxye- GCS . (SeL lx0±01
ISSUED TO:SUBDIVISION LOT—
NEW CRI REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: 4&Z Ce(osKS14' 5 =r1
Proposed Wastewater System T pe: ar 9b p
Projected Daily Flow. bio GPD
Number of be�dmo�� Number of Occupants: P3 max
Basement efidl's ❑ No
Pump Required: ❑Yes ❑ No �af✓J'N yfb �9ureed based on final location and elevations of facilities
Type of Water Supply: ❑ Community PLY ublic ❑ Well Distance from well rv+k, feet
Permit conditions:
Permit valid for.
ivL7F a years
❑ No expiration
Authorized State Agent: or' Date: p31y?4VQQ/Yei 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 pmyisiom 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 me(. Systems shall be installed in accordance
with the arached system layout
ISSUED TO: X*,)rM6 9 114dir., C --A xcr - PROPERTY LOCATION: S3UPc�>G Lc,ICP_JSCL
SUBDIVISION LOT #
Facility Type: qf2fl,��15 15E� 2-%ew ❑ Expansion ❑ Repair
Basement? ❑ Yes o Basement Fixtures? ❑ Yes ❑ No
Type of Wastewater System" '26%Q Cc -,n 'S,&& . (Initial) Wastewater Flow: GPD
(See note below, if applicable ❑) 26c�
�Yh (Zei;AiX -CU c x Sig (Repair)
Installation Requirements/Conditions Number of trent es .3
Septic Tank Size t aScp gallons Exact length of each trench I 0iC5 feet
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of: inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
Pump Requirements: ft. TDH vs. GPM
Conditions:
Trench Spacing: ? Feet on Center
Soil Cover. G inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
P --A inches below pipe
Depth: tr J k inches above pipe
TO 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.
"If applicable: / understand the system type specified is different from the type speciffed on the application. / accept the cpeuflcationr of this permit
Owner/Legal Representative Signature: Date:
This construction Authorization is subieu to revocation if the site elan. that or the intended use rhanoes. The Construction Authmization shall not he oam&,red when there is a chance in ownerahin of the cin. Thio
Construction Authorization is subject to compliance with the provisions of the Laws and Rules for Sewage Treatment and Disposal and is the conditions of this permit ltt AIIALHLU lilt MILK
Authorized State Agent: 61, Date: 031,9:1
C -Ad Tat til Construction Authorization Expiration Date: g3 21� J00
HTE# 1�u' -L) 3a1� Permit # R9C//aS(
Harnett County Department of Public Health
Site Sketch
pp _ PROPERTY LO[ATON: s� pj L, V,- al. (5,Z -k5
ISSUED TO: �>An1 eb O A�Su �S SUBDIVISION LOT #
Authorized State Agent: % � - � �j�' Date: �3 �� �Q ,/R
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