IPAC RHTE# C- 5,00- 1 5 i A Harnett County Department of Public Health
Improvement Permit 2 6 5 0 2
A building permit cannot be issued with only a Improvement Per it
tt~~ PROPERTY LOCATION: G s c~
ISSUED TO:! a~~ 5^ f Ie 5 SUBDIVISION #
NEW`' RE IR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: A~
Proposed Wastewater System Type: 15 ,CV\ ccw
Projected Daily Flow: (PlD GPD
Number of bedrooms: > Number of Occupants: max
Basement ❑Yes )5 No
Pump Required: ❑Yes ❑ No May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community 5K Publi ❑ Well Distance from well 1 Oz~ feet Permit valid for: 0 Five years
Permit conditions: a~ g S, r ft;o cY"t. N dJ S-A a f~+= t~ s ❑ No expiration
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Authorized State Agent:: ~ \ b i--1 Date: Q`~~ 0q- I V 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
Reauired for Building Permit
The construction and installation requirements of Rules .1950, .1952, .1954, .1955, .1956, .1951, .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. l
ISSUED T0: PROPERTY LOCATION: ooc"15
SUBDIVISION C
I~ ~aE,~\t (1 S LOT # a`Z"7
Facility Type: -sz~kA3° 313-C New ❑ Expansion ❑ Repair
Basement? ❑ Yes 5~, No Basement Fixtures? ❑ Yes CYNci
Type of Wastewater System** as4l- (Initial) Wastewater Flow: 3L, ~ GIRD
(See note below, if applicable
3 ~3 L~ (Repair)
Installation Requirements/Conditions Number of trenches t
Septic Tank Size NZQ-0 gallons Exact length of each trench 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: .3 inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
inches below pipe
Aggregate Depth: inches above pipe
inches total
WATER LINES (INCLUDING IRRIGATION) MUST BE 10FT. 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 specified on the application. / accept the specifications 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 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 SKtICH
\ n Date: p 3' o q
Authorized State Agent:
Construction Authorization Expiration Date: 0 -a 0
''1
HTE# 06-5-00 ~ 1 ql ~ Permit # 6 5-0 Q
Harnett County Department of Public Health
Site Sketch
f PROPERTY LOCATON: c 1 0j
ISSUED TO: ~1c I SUBDIVISION ~I/ave ~ I H. I\ LOT #
Auth iz" State Agent: Date: tl 0,4- 6~o ► I
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