IPAC RHTE# 2° -1-1-1-C,'-) ar .it County Department o Public uealth 25604
Im
provement Permit
A building permit cannot be issued with only an Improvement Permit
-4
PROPERTY LOCATION: 3-'7 LJP- S4
ISSUED TO:
r1~~ y-
ti 5
,c ; C
SUBDIVISION ! ee J
LOT #
NEW P'
REPAIR ❑
EXPANSION ❑
+
Site Improvements required prior to Construction Authorization Issuance:
Type of Structure:
0
s/X
1( S/.2'
Proposed Wastewater System Type:
)Li
Projected Daily Flow:
V C'
GPD
Number of bedrooms:
Basement ❑Ye
s
10No
_
Pump Required: 2fes
❑ No
Type of Water Supply:
❑ Community
Permit conditions:
Number of Occupants: G max
❑ MMaa be required based on final location and elevations of facilities
A public ❑ Well Distance from well feet
Permit valid for:
(--Five years
❑ No expiration
Authorized State Agent:: V-ft , ~ Y W r-- lr. J Date: Y ~ C ~ 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 provisions of
the Laws 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 shall be met. Systems shall be installed in accordance
with the attached system layout.
ISSUED TO: td`tw ,s4Y°,s C . t PROPERTY LOCATION: v -z:-4 SUBDIVISION IE- LOT # ~;7
Facility Type: J-i' 0 R New ❑ Expansion ❑ Repair
Basement? ❑ Yes IiKNo Basement Fixtures? ❑ Yes ❑ No
Type of Wastewater System** v e (Initial) Wastewater Flow: GPD
(See note below, if applicable
(Repair)
Installation Requirements/Conditions Number of trenches f
Septic Tank Size d0~-', Ct gallons Exact length of each trench t feet
Pump Tank Size /r gallons Trenches shall be installed on contour at a
Maximum Trench Depth of: inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
Pump Requirements: ft. TDH vs. GPM
Conditions: .s,.- r%4"' t go^
Trench Spacing: Feet on Center
Soil Cover: inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
inches below pipe
Aggregate Depth: inches above pipe
inches total
v iw I do t
**If applicable: l understand the system type speciled is different from the type speciled on the application, l accept the specifications 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
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
3" A c f `F~/~,/fzG
Authorized State Agent: Date:
X2
Construction Authorization Expiration Date: b3''ht'` 5f
HTE# j~J-- Z.2.IQ Permit # Y -C
Harnett County Department of I' blic Health
Site Sketch
PROPERTY LOCATON:
_-F
ISSUED T0: ~,<rs~► ~g A v~'~-:. SUBDIVISION' LOT #
Authorized State Agent: ,z
Date: y' /,2,f/2 ( y
I//
r
IC
Aft
:joutheastern Soil nviron mental Associates, c.
P.O. Sox 9321
Fayetteville, NC 28311
Phone/Fax (910) 822-4540
Ema t mike@southeasterneoil.com
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SOIUSITE EVALUATiCN * SOIL PHYSICAL ANALYSIS • LAND USE/SUBDIVISION PLANNING
CAO(.Ik'L)kA1A'CFr( DRAIN (.E'I~A3Ut4L)INC - SURFACEISURSURFACP WASTE TR5ATM NT SYSTEMS, EVALUATION & DESIGN