IPACHTE# 4i 5- Qn Harnett County Department of Public Health
Improvement Permit
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A building permit cannot be issued with only an Improvement Permit
ISSUED TO: r~n,gMg -
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PROPERTY LOCATION: QvF.s2~y0us
NEW ❑
REPAIR ❑
Type of Structure: V S ° ,,3
o
EXPANSION
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SUBDIVISION
Site Improvements required prior to Construction Auth
LOT
#
orization Issuance:
Proposed Wastewater System Type:
a T"Ir) CLEp~~,5~
Projected Daily Flow: ~d
GPD
Number of bedrooms:
Number of Occupants:
max
Basement ❑Yes
Pump Required: ❑Yes 12-No
❑ May be required based on
final location and elevations of facilities
Type of Water Supply: ❑ Community =41 Public ❑ Well
Permit conditions:
Distance from well _1 C) Q feet
Permit valid for.
Five years
❑ No expiration
Authorized State Agent:: Q.
The issuance of this permit by the Health Department in no way guarantees the iss c
site is subject to revocation if the site plan, plat, or the intended use changes. The Impr
the Laws and Rules for Sewage Treatment and Disposal and to conditions of this permit..
Date t ` I ) \ SEE ATTACHED SITE SKETCH
other permits. The permit holder is responsible for checking with appropriate governing bodies in meeting their requirements. This
Permit shall not be affected by a change in ownership of the site. This permit is subject to compliance with the provisions of
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 be installed in accordance
with the attached system layout.
ISSUED TO: PROPERTY LOCATION: QvEct~l~t~ S gp
SUBDIVISION 5-~oN s
Facility Type: 15X36 PNoo ~-c, a El New LOT # _
Basement? El Yes No Basement Fixtures? ❑ Yes' Expansion El Repair '1R, No
Type of Wastewater System**
(See note below, if applicable (Initial) Wastewater Flow: 1~00 GPD
Installation Requirements/Conditions Number of trenches 1 (Repair)
Septic Tank Size )NC, gallons Exact length of each trench Gn feet Trench Spacing
Pum Tank Size Feet on Center
p gallons Trenches shall be installed on contour at a Soil Cover: 1a a.~} inches
Maximum Trench Depth of., c~-,A--5G inches (Maximum soil cover shall not exceed
(Trench bottoms shall be level to +/-1/4" 36" above the trench bottom)
in all directions)
Pump Requirements: ft. TDH vs. GPM
inches below pipe
Conditions: tJ~„ LiNEo _ \ Aggregate Depth: inches above pipe
•`+G'l..t~1G,~, i SNG !►1 n'~ `--~-655'4 O s'
LO US G
inches total
WATER LINES (IN(LUDING IRRIGATION) MUST BE LOFT. FROM ANY PART OF SEPTIC SYSTEM OR REPAIR AREA.
NO UTILITIES ALLOWED IN INITIAL OR REPAIR DRAIN FIELD AREA.
**If applicable f understand the system type specified is different from the type specified on the app/icatiom / accept the specilcations of this permit.
Owner/Legal Representative Signa :
This Construction Authorization is subject to revocation i to plan, plat, or the inten~fr nge. The fonsta.dDi thorization st be tr~th en tDhere eis a cwnership of the iteThis
fonstructioAuthorization is compliance the s Laws and Rage Treatment al and to th e conditions t. ATTACHEDS ITE SKETCH
Authorized State Agent: 4-ths Date: a ll
Construc Authorization Expiration Date.=-,
NTE# 11-5 -~}gb`b
ISSUED TO:
Authorized State Agent:
Permit # a~
arnett County Department of Public Health
Site Sketch
PROPERTY LOCATON: Q vC-S~VIA11- ~.U
Y-11" SUBDIVISION S, d NEc~z oss LOT #
{LC3'b ~1~ Esz ~ov,o Date: i >1 11 \
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