IP-OnlyHTE# -43957 Harnett County Department of Public Health 30067
Improvement Permit
A building permit cannot be issued with only an Improvement Permit S 2 1 a -:4 v
PROPERTY LOCATION: a'S s ' IQ -J �U t� eorz tL
ISSUED T0: C>Lk\ �T N�N(Fl� SUBDIVISION lco— LOT #
NEW REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: S
Proposed Wastewater System Type: kv,CPJ v p
tic � GPD 1tpt�S G)e I (O L i A.166 �Lv�S frfQ��
Projected Daily Flow: t
Number of bedroom$:Number of Occupants: TO max
Basement ❑Yes o Gkew`��1a��
Pump Required: es ❑ No ❑ May be required basil Irmal location and elevations of facilities
Type of Water Supply: ❑ Community ❑ Public ell Distance from well 1 ) feet rH a eJ� Permit valid for. ivL�F a years
Q�a�iZTr'kM `-toI 1 : G ,
Perm conditions: , S (Z2pcs �sOE ) r^n ❑ No expiration
Authorized StYete Agent:: ' Date: d61 �C�l � SEE ATTACHED SITE SKETCH
The issuance of this permit by the ealsh Department in no way guarantees the issuance of other permits. The permit holder is responsible for checking wish appropriate governing bodies in meeting their requiremenm. 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, .1951, .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
ISSUED TO:
Facility Type: ❑ New
Basement? ❑ Yes ❑ No Basement Fixtures? ❑ Yes
Type of Wastewater System** _
(See note below, if applicable ❑)
Installation Requirements/Conditions
Septic Tank Size gallons
Pump Tank Size gallons
PROPERTY LOCATION:
SUBDIVISION .
❑ Expansion
❑ No
❑ 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)
Pump Requirements: h. TDM vs. GPM
Conditions:
LOT #
(Initial) Wastewater Flow:
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.
GPD
inches below pipe
inches above pipe
inches total
If applicable: / understand the system type specified is different from the type speciffed on the application. / accept the cpecifcations of this permit,
Owner/Legal Representative Signature: Date:
This Construction Authorization is subject M revocation it the site plan, plat or the intended we changes. The Construction Authorization shall not be transferred when there is a change in ownership of the site. This
tonstmcnon Authorization is subject M tompllana with the provisions of the Laws and Rules for Sewage Treatment and Disposal and to the ronditiom of this permit att At IACNtD Ills )RtICN
Authorized State Agent: Date:
Construction Authorization Expiration Date: