IPAC RHTE# Q?-»(3-x39;2 Harnett County Department of Public Health 2 5 2 3 2
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: L
ISSUED TO: Qv Y C SUBDIVISION F~ 1~~ 17 n k S LOT #
L
NEW REPAIR ❑ EXPANSION ❑
Type of Structure: Site Improvements required prior to Construction Authorization Issuance:
- -
Proposed Wastewater System Type:
Projected Daily Flow 3L.;~ GPD
Number of bedrooms: 3 Number of Occupants: _41max
Basement ❑Yes *_No
Pump Required: ❑Yes ❑ No --~4ay be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community 15K Public ❑ Well Distance fro well I29J feet Permit valid for Five years
Permit conditions:o r! t 7k scl
k y4 c No expiration
(I A, I_ i _ I I I _ r I 3"k-14 11 No expiration
Authorized State Agent: Date: ` SEE ATTACHED SITE SKETCH
The issuance of this permit by the ne Department in no way guarantees the issuance of other permits. The permit holder is onsible for checkin with aropriate governing bodies in meeting th q
eir reuirements. This
site is subject to revocation if the ' e plan, plat, or the intended use changes. The Improvement Permit shall rot be affected byreasp change in ownership g of the si ppte. 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, .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 IayouL
ISSUED TO: V t h c SJ L.c-, d PROPERTY LOCATION: 2--
SUBDIVISION ~9ffS7 yNk1 LOT # o~C
Facility Type: 3 ro '-;c x 3T ' P -~Z New ❑ Expansion ❑ Repair
Basement? ❑ Yes &~-_No Basement Fixtures? ❑ Yes Q,49
Type of Wastewater System** v t (Initial) Wastewater Flow: GPD
(See note below, if applicable'
tS°~a~u c~~ S f (Repair)
Installation Requirements/Conditions Number of trenches
Septic Tank Size 000 gallons Exact length of each trench . I- feet
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of, JY- tt inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
Pump Requirements: ft. TDH vs. _ GPM
Conditions:
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
*`If applicable: / underfta~rd the ,ryrtem type ,rpeci6ed if different from the type ,rpeci6ed on the app/icatiaa /accept the rpecificationr of Chit 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 ho mnndnrvnd Whll sore
Construction Authorization is subject to corn fiance 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 Agent: - Q Date: W- 1~ y
Construction Authorization Expiration Date: 1017 - 00/`(
HTE# Qj 5b0- ~t 3~0? 2 Permit # a
Harnett County I)epartment of I-~ blic Health
Site Sketch
PROPERTY LOCATON: 7
ISSUED TO: env, Y\(, ss L'~)ncl SUBDIVISION 1JAC) 7 Drl ►c s LOT # /,.;?L
Authorized State Agent: Date:
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