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IP-ONLYHTE# Ig-6-`i36co Harnett County Department of Public Health 29936 Improvement Permit A building permit cannot be issued with only an Improve4�ent Permit y��y PROPERTY LOCATION: �o; f ael Gre¢l C U r SS ISSUED T0: Ac le, Q)ot t�G SUBDIVISION ('a,n�1 S C;ca�l/— �—c.s MS LOT# NEW REPAIR ❑a EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance: Type of Structure: !16 '1a K430t Z Proposed Wastewater System T pe: 095 ��0 VA -;QA 5u5 Projected Daily Flow: GPD Number of bedrooms: Number of Occupants: 8 max S ; !-& 6bekA 1R--- 08 c—\ col SEnx:t,_tr.- Basement ❑Yes o C—fuC nw.rb(O—A Pump Required: s ❑ No ❑ May be required base Inal location and elevations of facilities _ �— Type of Water Supply: El Community El Public stance from well feet oAi'� Permit '(lid for. Lia a years Permit conditions: Q4A-1,r Cvt ��mn r 5� � — (� ✓ Y ) r O�c ❑ No expiration Authorized State Agent:: eo Date: ©N 1 t q I onig 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 Deposal and to conditions of this permit.. Construction Authorization (Required for Building Permit) The construction and installation requirements of Rules .1950, .1957, .1954, .1955, .1956, .1957, .1958. and .1959 art incorporated by references into this permit and shall be met. Systems shall be installed in accordance with the attached system layout. ISSUED TO Facility Type: Basement? ❑ Yes ❑ No Type of Wastewater System" (See note below, if applicable ❑) PROPERTY LOCATION: SUBDIVISION ❑ New ❑ Expansion Basement Fixtures? ❑ Yes ❑ No Installation Requirements/Conditions Septic Tank Size gallons Pump Tank Size gallons Pump Requirements: N. TDM vs. Conditions: ❑ Repair Number of trenches Exact length of each trench Trenches shall be installed on contour at a Maximum Trench Depth of: (Trench bottoms shall be level to +/-1/4" in all directions) GPM LOT # (Initial) Wastewater Flow: GPD feet Trench Spacing: Feet on Center Soil Cover: inches inches (Maximum soil cover shall not exceed 36" above the trench bottom) Aggregate Depth: WATER LINES (INCLUDING IRRIGATION) MUST BE LOFT. FROM ANY PART OF SEPTIC SYSTEM OR REPAIR AREA. NO UTILITIES ALLOWED IN INITIAL OR REPAIR DRAIN FIELD AREA. inches below pipe inches above pipe inches total ""If applicable: / understand the system type rpeciled is different fmm the type specified on the application. / accept the rpealeat6onJ of this permit Owner/Legal Representative Signature: Date: This Construction 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 Authorized State Agent: with the provisions of the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH Date: Construction Authorization Expiration Date: