IPAC 2HTE# 1�'T—S—JOI
ISSUED TO:
NEW LSY A REPI
Type of Structure:
Proposed Wastewater System
Projected Daily Flow: 4 Lf U GPD/ c/
Number of bedrooms: " Number of Occupants: ` L max
EP o
L 0 0 May be 'red b on final location and elevations of facilities
ElCommunity ublic Distance from well I C'U feet�r AMUPe `aid .
Harnett County Department of Public Health 30070
Improvement Permit
A building permit cannot be issued with only an Improvement Permit \
PROPERTY LOCATIONZ15 C, aV.eh ,nv 12-ct�`XL I qct 1
ON SUBDIVISION tJ LOT #�
1 ❑ Site Improvements required prior to Construction Authorization Issuance:
Basement ❑Yes
Pump Required: Dyes
Type of Water Supply:
Permit conditions:
❑ No expiration
Authorized State Agent: Date: �� r It— 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 pmvisiom of
the Caws 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, .1952, .1954, .1955, .1956, .1951, .1958. and .1959 are incorporated by references into this permit and shali be met Systems shall be installed in accordance
with the attached system layout. \
ISSUED TO:-, LL, �i(i�m%��CL� PROPERTY LOCATION: A5- Ctli SlEna'H (LA (1_ . i ( Igo -g )
SUBDIVISION LOT #
Facility Type: a(3�i_ %C Z,51 SFtz> N'New ❑ Expansion ❑ Repair
Basement? ❑ Yes [�o Basement Fixtures? ❑ Yes ❑ No -s� ��
Type of Wastewater System** 1lj",QeeAN4, 'an �� (Initial) Wastewater Flow: Wit` GPD
(See note below, if applicable ❑) �S cy
C1 sr.: (Repair)
Installation Requirements/Conditions Number of trenches
Septic Tank Size I C)C"_1C') gallons Exact length of each trench - feet
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of.. _ e��L inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
Pump Requirements: (t. TDH vs. GPM
Conditions:
Trench Spacing: 7 Feet on Center
Soil Cover. - (6 inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
c!'I A inches below pipe
Depth: ru I'— inches above pipe
QN 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: / naderrtand the ryrtem type spec/bed it different from the type spec*d on the app/ication. / accept the rpecih'cationr of this permit
Owner/Legal Representative Signature: Date:
This Construction Authr ation is subject to revocation if the site plan, plat, or the intended use changes. The Construction Authoriatiot shall not be transferred when there is a change in ownership of the site. This
Construction Authorization is subject a compliance with the provisions of the Caws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent: / Date: d61d�IdgB
A wlnr ur—_Av Y- .. ,n—,a-itv Construction Authorization Expiration Date: �°la land
HTE# I�'S— q q lo( Permit # 3 C)04�-
Harnett County Department of Public Health
Site Sketch
PROPERTY LOCATOR:(C, r,�5,L IL63)
ISSUED TO: aI(1 5no X �Ct�Lgr q SUBDIVISION LOT #
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Authorized State Agent: Date:C�4/c7-7/Foe
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