IPAC RRHTE# l/T-6 -4a I QV- Harnett County Department of Public Health 29800
hDrovement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: I af4 Re,_ucAe_ Or . (2n11i45 tl - 52. A{43)
ISSUED TO: CQ Aisa iiar,1t 140ALQ TAC, SUBDIVISION — _ fte_5ex_(J LOT #
NEWREPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: 302 —1z? K)c+"Tv 59:�
Proposed Wastewater System Type: Q5 i- 5,5,
Projected Daily Flow: 3 (" d GPD
Number of bedrooms: 3 Number of Occupants: max
Rxomont FlYoc DI -
Pump Required: ❑Yes
Type of Water Supply:
Permit conditions:
❑ No f awl �PC y �be aced on final location and elevations of facilities
❑ Community ubILYP is ❑ Well Distance from well feet
Permit valid for. 9—FivtYrars
❑ No expiration
Authorised State Agent: [Gly_i'40ii Date:—�,—'�^so SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the issuance of other permit. The permit holder is responsible for checking with appropriate governing bodies in meeting their requirement, 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 provision of
the Laws and Rules for Sewage Treatment and Disposal and to conditions of this permit..
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 spedled is different hom the type speciled on the app/motion. / accept the rpecih'caaonr of this permit
Owner/Legal Representative Signature: Date:
This Construction Authorization is subject to revocation if the sit 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 provisions of the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE
Authorized State Agent Date:
F - %,J:' t a GGvtt-0-4N.s Construction Authorization Expiration Date:
Construction Authorization
(Required for Building Permit)
The constrottion and installation requirement of Rules .1950, .1952, .1954, .1955, .1956, .1957, .1958. and .1959 arc 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: i s S -s
M.scrvc 10c. CIDA $,A$ 2.k Svc LeAl3�
SUBDIVISION ZGaa_
LOT # 4
Facility Type: 32 -:319'x q a' S � 13-1iw ❑ Expansion ❑ Repair
Basement? ❑ Yes to Basement Fixtures? ❑ Yes ❑ No
Type of Wastewater System" Q
(Initial) Wastewater Flow: 36y GPD
(See note below, if applicable ❑)
a5% /
Axl nn S�—(Repair)
Installation Requirements/Conditions
Number of trenches
Septic Tank Size y ooc-> gallons
Exact length of each trench feet
Trench Spacing: `7 Feet on Center
Pump Tank Size gallons
Trenches shall be installed on contour at a
Soil Cover: / a inches
Maximum Trench Depth of: OV 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: ft. TDM vs.
GPM
�A inches below pipe
Aggregate Depth: 1-3 P.- inches above pipe
Conditions:
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 spedled is different hom the type speciled on the app/motion. / accept the rpecih'caaonr of this permit
Owner/Legal Representative Signature: Date:
This Construction Authorization is subject to revocation if the sit 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 provisions of the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE
Authorized State Agent Date:
F - %,J:' t a GGvtt-0-4N.s Construction Authorization Expiration Date:
HTE# ya%U/ R--(;?- Permit# IdC,ec)b
Harnett County Department of Public Health
Site Sketch
ISSUED TO:
Authorized
PROPERTYLO[ATON: Ia5 Q ---sr v Q-;v-e-CRall'A5 a-A-5.1t,/qt3
SUBDIVISION v, ae-sk isLOT #
Date: Ale 3
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