IPAC RRType of Structure: Sd
Proposed Wastewater System Type:
Projected Daily Flow: 3tvo GPD
Number of bedrooms: Number of Occupants: max
Basement ❑Yes No
Pump Required: ❑Yes ❑ No I~Pub requi red based on final location and elevations of facilities
Type of Water Supply: ❑ Community lic ❑ Well Distance from well feet
Permit conditions:
Permit valid for:
2'Five years
❑ No expiration
Authorized State Age Date: /f- 5 =a$ SEE ATTACHED SITE SKETCH
The issuance of this permit by t alth 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 t e 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 Bun Pg ermit)
The construction and installation requirements of Rules .1950, .1952, .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: -,l.tl t . __)5~vyb j-,#11, 4 PROPERTY LOCATION: L -'17-
SUBDIVISION LOT #
Facility Type: S~ New pension ❑ Repair
Basement? ❑ Yes No Basement Fixtures? ❑ Yes Eallo
Type of Wastewater System" Z~5-% f71 bUr-FW0 5. -c (Initial) Wastewater Flow: 34,-0 GIRD
(See note below, if applicable
Z5' 0''> /LC us'L (Repair)
Installation Requirements/Conditions Number of trenches 4
Septic Tank Size c, gallons Exact length of each trench jZ) feet
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of: Z®' inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
Pump Requirements: ft. TDH vs. GPM
Conditions:
Trench Spacing: f2' Feet on Center
Soil Cover: C,::2 inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
C, inches below pipe
Aggregate Depth: -Z inches above pipe
j 7 inches total
**If applicable: /understand the system type specified /s different from the type specified on the application. / accept the soecif1wionr of this permit.
Owner/Legal Representative Signature: Date:
This Construction Authorization is subject to revocation if the site 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
Lonstructmn 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. SILL ATTACHED SITE SKETCH
Authorized State Agent. Date: //-5T-e3 Z if
Construction Authorization Expiration Date: Cr_-6✓3 •4?-z-3--rt~
HTE# C-7 - S _ f 1922 R,12
Permit # Z 51,9 ;7
Harnett County Department of l~iblic Health
Site sketch
_ PROPERTY LOCATOU4 ~ Z-
ISSUED TO: SUBDIVISION -~x"Jdct,~ s LOT # 3
Authorized State Agent: 't Date: 5 = 68 6- Z.3 -tl
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