IPAC RHTE# K3-5- 43y(15 921
ett County Department of Public Health 29
Improvement Permit
A building permit cannot be issued with only an Improvement Permit 164
PROPERTY LOCATION: GIS 6otet, creed Sti
ISSUED TO �A tYtfLr`y Cr! s_Cj f SUBDIVISION LOT #
NEW EK REPAIR ❑ hPANSION ❑
Type of Structure: q 6 e G5 x W,' 5=5>
Proposed Wastewater System ,T]p�e: _�0, `1% (to
Projected Daily Flow: Q GPD
Number of bedrooms: tt�f Number of Occupants: mace
Ro Ari rIYwe
Pump Required: ❑Yes
Type of Water Supply:
Permit conditions:
Site Improvements required prior to Construction Authorization Issuance:
❑ No (3 ay bb "°ired based on final location and elevations of facilities
El Community fsd' Public ❑ Well Distance from well N feet
Permit valid for.
Rl�iv_eyears
❑ No expiration
Authorized State Agent:: r= 5 Date: '--3 f A'_yl act '�5 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 isresponsible 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.
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: l understand the r}rtesm type ipeciled it different from the type rpeciled an the application. is accept the tpecilcationr of this permit
Owner/Legal Representative Signature: Date:
This construction Authorization is subject to revocation if the site plan, plat or the intended we changes. The construction Authoritarian 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 SKETCH
Authorized State Agent: ��r/ / � Date: a4ftsla" a
Construction Authorization Expiration ts{W--
Construction Authorization
(Required for Building Permit)
The construction and installation requirements of Rules .1950..1951,
.1954, .1955, .1956, AM, .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:'S�i swS� S Le E�
15"Si
g 2� PROPERTY LOCATION:
SUBDIVISION
Facility Type: 4mL as t vis 5^� ET New ❑ Expansion ❑ Repair
LOT #
Basement? ❑ Yes o Basement Fixtures? ❑ Yes ❑ No
Seo A1C
Type of Wastewater System**
��z`/z� ✓l.a.��tor� 5,5 �M
(Initial) Wastewater Flow:
(See note below, if applicable ❑)
6eoC5;a� /
e %s
fZeA X- —ion 5> s (Repair)
� pp 64DL5 1
Installation Requirements/Conditions
Septic Tank Size t a5c7 gallons
Number of trent �
Exact length of each trench 1 CSO feet
J
Trench Spacing: Feet on Center
Pump Tank Size gallons
Trenches shall be installed on contour at a
Soil Cover. inches
Maximum Trench Depth of: 9 itlf� inches
(Maximum soil cover shall not exceed
(Trench bottoms shall be level to +/-1/4"
36" above the trench bottom)
in all directions)
Pump Requirements: ft. TDH vs.
GPM
r -i N inches below pipe
Aggregate Depth: t'jA inches above pipe
Conditions: C ir\
V>�S£Cl 6Q-6Q>C)
✓J .4- 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: l understand the r}rtesm type ipeciled it different from the type rpeciled an the application. is accept the tpecilcationr of this permit
Owner/Legal Representative Signature: Date:
This construction Authorization is subject to revocation if the site plan, plat or the intended we changes. The construction Authoritarian 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 SKETCH
Authorized State Agent: ��r/ / � Date: a4ftsla" a
Construction Authorization Expiration ts{W--
\c6 -S -,43y90 (,sF\t--'t
HTE# Rx -6-q341;3610- (s Permit # 9 a
Harnett County Department of Public Health
Site Sketch
Isla
PROPERTY LO(ATON: GIS 0vte-b LCeea-- aZl.i 5rL
ISSUED TO: SUBDIVISION LOT #
0c/1,61acks
Authorized State Agent: i Date:
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