IPACHTE# 1$'S-L1uo71W Harnett County Department of Public Health 30122
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: a3C r�5 v Po Na LH .
ISSUED TO: o2D SUBDIVISION LOT # 13
NEW ❑ REPAIR ❑ EKPAjlSION
Type of Structure: M Para 13 oc.+6 kA r7
Proposed Wastewater System Tyyppe: aFz"la P.EovG t I.
Projected Daily Flow: GPD
Number of bedrooms: t- s Number of Occupants: max
Basement ❑Yes �Kilo
Site Improvements required prior to Construction Authorization Issuance:
Pump Required: ❑Yes eT3.110 ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community ;K Public ❑ Well Distance from well feet Permit valid for.Five years
Permit conditions: \ \ No expiration
Authorized State Agent: 7!�!W&r)s , Date: 1 �31.1R SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the issu other permits. The permit holder is responsi le 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 Improvem t Permit shall not be affected by a change in ownership of the site. This permit is subject to compliance with the provisions of
the taws 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 aaordmce
with the attached system layout c
ISSUED TO: CLP, rs a r \ ocsi oP . o',j my PROPERTY LOCATION: a36 S-9 I" Pa
SUBDIVISION LOT # 13
Facility Type:flN.1Xome ;,�-?❑ New XExpansion ❑ Repair
Basement? ❑ Yes No Basement Fixtures? ❑ Yes ❑ No
Type of Wastewater System** WLo 9,GOvC.:TN o,a cz-Y15 GM (Initial) Wastewater Flow: "0 GPD
(See note below, if applicable ❑) a�� p
lrliZj l'7.0N`�Pf„ PHnG-t— 9WCX- (Repair)
Installation Requirements/Conditions Number of trenches 1
Septic Tank Size Qs t,S' s. t gallons Exact length of each trench -Is- feet
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of: 1Q inches
(Trench bottoms shall be level to +/.I/4"
in all directions)
Pump Requirements: ft TDH vs. GPM
Trench Spacing: Feet on Center
Soil (over. re inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
Conditions: Paco p" '-Co Fwo cng I,jzhs'S tsa L flM1iz'% s 1_1 NL -
Aggregate Depth:
WATER LINES (INCLUDING IRRIGATION) MUST BE LOFT. FROM ANY PART OF SEPTI( SYSTEM OR REPAIR AREA.
NO UTILITIES ALLOWED IN INITIAL OR REPAIR DRAIN FIELD AREA.
inches below pipe
inches above pipe
inches total
**If applicable, / ondeatand the r)ttem type specified /t dih"erent hum the type rpe6fed on the application. / accept the upeafkationr of this permit
Signature:
Date:
This Construction Authorization is su sevoalron it the site plan, plat or the intended use changes. The Construction Authorization shall not be transferred when there is a change in ownership niche site. This
Construction Authorization g suhea to complia ons of the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent: YGtiS Date:
action Authorization Expiration Date. '� }3
HTE# S -14 LA CJ Cl Permit # %01 as
Harnett County Department of ll�tblic Health
Site Sketch
PROPERTY LOCATON:
ISSUED TO: C �1 1�o�L> eFSn.NFO2 SUBDIVISION LOT #
Authorized State Age.+(�Q- 101-4sDor� Date: ilii'>Q
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