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IPAC RHTE# - - io7 3iZ Harnett County Department of Public Health Improvement Permit 2 6 8 2 3 A building permit cannot be issued with only an Improvement Permit PROPERTY LOCATION:5)Z / Z z r 20 ISSUED T t SUBDIVISION LOT # NEW REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance: Type of Structure: 4n 1 &u . AV Proposed Wastewater System Type: 2-5'-4/ +tr't.,fP~4,rv-_ "As~ Projected Daily Flow: 4 GPD Number of bedrooms: ~ Number of Occupants: max Basement ❑Yes 2_'N Pump Required: ❑Yes ❑ No L+l Mae required based on final location and elevations of facilities Type of Water Supply: ❑ Community L~''1 Public ❑ Well Distance from well feet Permit valid for: L/J Five years Permit conditions: ❑ No expiration Authorized State Agent::. _ rs Date: 2 SEE ATTACHED SITE SKETCH The issuance of this permit by a 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. f ISSUED TO: Too) t, Ir ko,~Wftr PROPERTY LOCATION:'kI=®a~ L 141; z:~c SUBDIVISION LOT # Facility Type: t2c 'L 4-A- EZ( New ~a-" Expansion ❑ Repair Basement? ❑ Yes No Basement Fixtures? ❑ Yes 1 No Type of Wastewater System** 7%r' dpi) ~ f3- (Initial) Wastewater Flow: GPD (See note below, if applicable &hY Li (Repair) Installation Requirements/Conditions Number trenches Septic Tank Size f20 0 gallons Exact length of each trench feet Trench Spacing: Feet on Center Pump Tank Size gallons Trenches shall be installed on contour at a Soil Cover: - inches Maximum Trench Depth of. vq" 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 46 inches below pipe Aggregate Depth: inches above pipe Conditions: i Z_ inches total WATER LINES (INCLUDING 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: /understand the system type speciped is different from the type specired on the application. / accept the specif2mions 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 chance in ownershia of the site. This Lonstruction 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 Authorized State A S Date: 2 - % 2- Construction Authorization Expiration Date: 5 - 1 -7 HTE# J? -5'~- 770-7 5 iZ- Permit # 2&' Z 3 Harnett County Department of 11ablic Health Site Sketch PROPERTY LOCATON: 1J5'Z A44,0vvr-'-' i?o ISSUED T0: 4-A~+,,~ SUBDIVISION LOT # Authorized State Ag : ---r lr Date: mot. c~~ 3 'ilk