HomeMy WebLinkAboutIPAC RHTE#o'J Harnett County Department of Public Health 2 5 5 6 9
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: ~~~nEa
ISSUED T0: ~EN rFc~ SUBDIVISION LOT #
NEW REPAIR ❑ EXPANSION
Type of Structure: r'T t~~+ , 1~o c~6 ~3~ x60
Proposed Wastewater System Type: ~rayEni,~osyD 1.
Projected Daily Flow: GPD
Number of bedrooms: 3 Number of Occupants: max
Basement ❑Yes No
Site Improvements required prior to Construction Authorization Issuance:
Pump Required: ❑Yes ❑ No X May be required based on final location and elevations of facilities t
Type of Water Supply: ❑ Community Public ❑ Well Distance from well s bQ feet
Permit conditions:
Permit valid for: X Five years
❑ No expiration
Authorized State Agent:: Z. Date: SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the asTdnce er permits. The permit hofder is responsi le far 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 it 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: PROPERTY LOCATION:
SUBDIVISION LOT # c~
Facility Type: C x New ❑ Expansion ❑ Repair
Basement? ❑ Yes No Basement Fixtures? ❑ Yes No
Type of Wastewater System** Co'-4J CJ t4
o L (Initial) Wastewater flow: 3~b GPD
(See note below, if applicable
L_I (Repair)
Installation Requirements/Conditions
Septic Tank Size 1C2!7D gallons
Pump Tank Size gallons
Pump Requirements: h. TDH vs.
Number of trenches
Exact length of each trench SO feet
Trenches shall be installed on contour at a
Maximum Trench Depth of. inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
GPM
Trench Spacing: Feet on Center
Soil Cover: 6-1-.), inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
Aggregate Depth:
Conditions: -Ct ti,~ is A ~1~,,,, QCcZC~ , -
Q.c. cCsme,) `4 M v 0 4.4 C3 C -V,4 d Lon .
inches below pipe
inches above pipe
1 tCK inches total
**If applicable: /understand the ryrtem type specified it diHereat from the type specified on the app/ication. /accept the rpecificationr of this permit.
Owner/Legal Representative Signature:
This Construction Authorization is subject to revocat
Construction Authorization is subject to compliance
if the
Date:
plat, or the intended use changes. The Construction Authorization shall not be transferred when there is a change in ownership of the site. This
the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit. SEE ATTACHED SITE SKETCH
Authorized State Agent: Date: ~1 ac1
Con ion Authorization Expiration Date: 1 a
31
HTE# C) S i t4S' Permit # ~4, I
Harnett County Wpartinent of Public Health
Site ketch
PROPERTY LOCATON:
ISSUED T0: SUBDIVISION LOT #
Authorized State Agent: C2 ~~~`t To bT Date: 7 3
-3"~ 1