HomeMy WebLinkAboutIPAC RRHTE# 4 - S-- I o ~7 RR Harnett County Department of Public Health 2
Pq I ~ I ofes"~ f~ 3dcs Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATI N: LAJeR - C- c f ACI
ISSUED TO: ~ Q SUBDIVISION _ Kr~Y A~gt
NEW t
~KAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorizatii
Type of Structure: (ob OC 2M -I IVA.3 i 3S,, J
Proposed Wastewater System Type: C'~rtv~k,~. ra
Projected Daily flow: '3 G 'Z) GPD LLA1 0,, '4~ .Ia~1~ , dh
Number of bedrooms: X Number of Occupants: (0 max
Basement ❑Yes 2qo _ii n3 w a yh ,14a w,
Pump Required: ❑Yes ❑ No play be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community ❑ Public "5< ell Distance from well 00 feet Permit valid for
Permit conditions: MuJT (T1-«'(` 0tl Sq t r- C_-1YNAk LA, ~L - - :rt^ LfL/t LA)„f c 4t4 rf
i fs ~A e~a CC Inc L's n ( it s t fttK u
Authorized State Agent:: S Date: 06- / V-c) l- SEE ATTACHE
The issuance of this permit by the Heal epartment in no way guarantees the issuance of other permits. The permit holder is responsible for checking with appropriate governing bodies in meet
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 comp
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, 1957, .1958. and .1959 are incorporated by references into this permit and shall be met. Systems shall
with the attached system layout ~J
ISSUED TO: RQ- Cv r.c~ V' ~ S t
PROPERTY LO TION: l gL../ea'r-cc_ t?
SUBDIVISION taR,,',
Facility Type: S F 0 u`1' - 3130- New ❑ Expansion ❑ Repair
Basement? ❑ Yes No Bement Fixtures? ❑ Yes ZNo
Type of Wastewater System** (Initial) Wastewater Flow: -IJ
(See note below, if applicable IS
(Repair)
Installation Requirements/Conditions Number of trenches
Septic Tank Size - i' gallons Exact length of each trench (ry n feet Trench Spacing: Fee
Pump Tank Sae gallons Trenches shall be installed on contour at a Soil Cover: inch(
Maximum Trench Depth of: I ~Z inches (Maximum soil cover shall not i
(Trench bottoms shall be level to +/-1/4" 36" above the trench bottom)
Aggregate Depth:
2-
1 2
*If applicable: /understand the ryrtem type rpedfled it different from the type specified on the application. l accept the fpecifkmioar of this ~
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 owners[
Construction Authorization is subject to com _ nce th the provisions of the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTA
Authorized State Agent: -~L/,- - Date:` k 1~ - z'>
Construction Authorization Expiration Date:
in all directions)
Pump Requirements: ft. TDH vs. GPM
HTE# Oq- 5 1 QdX7 ~ Permit # a/ 0
Harnett County Department of ll~iblic Health
Site Sketch
PROPERTY LOCATON: LA AQ(
ISSUED T0: t _ SUBDIVISION ~a 1 LO
Authorized State Agent Date: 40
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