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IPAC RHTE# Harnett County Department of Public Health 29818 Improvement Permit A building permit cannot be issued with only an Improvement Permit A� PROPERTY LOCATION: PONOELLOSA ISSUED TO: ) -7 o�C 9>0 ) wcab \r A c. SUBDIVISION — LOT # NEWW'X REPAI ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance: Type of Structure: SF'9 LSS wC /(���L0 Proposed Wastewater System Type: QZVeo `F0,1ji\ON Syr6tr Projected Daily Flow: GOO GPD Number of bedrooms: L Number of Occupants: 10 max Basement []Yes �KNo Pump Required: ❑Yes '9 No ❑ May be required based on final location and elevations of facilities Type of Water Supply: ❑ Community "E4 Public ❑ Well Distance from well feet Permit valid for. Five years Permit conditions: ❑ No expiration Authorized State Agent: »7 Date: 13 Ya 11 1 } SEE ATTACHED SITE SKETCH The issuance of this permit by the Health Department in no way guarantees toe issuanc a er permiLL The permit holder n rssponsible 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 mi 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 perm .. OFiaj C)Qa) t� Construction Authorization (Required for Building Permit) The construction and installation requirements of Rules .1950, .1952, .1954, .1955, .1956, .1957, .1956. and .1959 are incorporated by references into this permit and shall be met. Systems shall be installed in accordance with the attached system layout t� ISSUED T0: I--YoN �y S Opti � N L PROPERTY LOCATION: Tots &Lc sp, SUBDIVISION LOT # a. Facility Type: `�F0ESS"�1� New ❑ Expansion ❑ Repair Basement? ❑ Yes X No Basement Fixtures? ❑ Yes 'XNo Type of Wastewater System" aS% 0 4 Sy�Tf� r (Initial) Wastewater Flow: GPD (See note below, if applicable ❑) D-�% P C1D- (Repair) Installation Requirements/Conditions Number of trenches 1 Septic Tank Size 1'a.S0 gallons Pump Tank Size gallons Pump Requirements: (t TDH vs. Conditions: Exact length of each trench 2'A0 feet Trenches shall be installed on contour at a Maximum Trench Depth of: It - inches (Trench bottoms shall be level to +/-1/4" in all directions) GPM Trench Spacing: �1 feet on Center Soil (over. Ea- 10 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 IV[ 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 specilred it different from the type specibed on the app/kation. / accept the specilcationc o/this permit. Owner/Legal Representative Signature: Date: This Construction Authonzatmn is subject tore ion if the sin 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 m compliance with misions of the laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit. SEE ATTACHED SITE SKETCH Authth 'ze� a Date: Ica J a> >7 . liltruction Authorization Expiration Date: NTE# S i -5- �la�d576L Harnett County ISSUED TO: Authorized State Agent: A Q% Permit # a NN't Department of Public Health Site Sketch PROPERTY LOCATON: Po No 5p i SUBDIVISION — LOT # Date: G )"I A �P�ggaS'n RID OL e p 0 L,