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IPAC RRHTE# \N Harnett County Department of Public Health ImDrovement Permit 27195 A building permit cannot be issued with only an Improvement Permit _ PROPERTY LOCATION: �HPs NvC ISSUED TO: �% oS'-N 0 k-, t �r.-I ® `� �� L SUBDIVISION Mpnoc 6 LOT # l� _ NEW ❑ REPAIR ❑ _ EXPAN�QN Site Improvements required prior to Construction Authorization Issuance: Type of Structure: N�o �-� o "J �33J Proposed Wastewater System Type: `� -�'�fP VG, s o N Projected Daily Flow: 0 GPD Number of bedrooms: Number of Occupants: 0 max Basement ❑Yes -�INo Pump Required: ❑Yes >� No ❑ May be required based on final location and elevations of facilities Type of Water Supply: ❑ Community 13. Public ❑ Well Distance from well feet Permit valid for: Five years Permit conditions: ❑ No expiration Authorized State Agent:: U-\A5 Date: `l 1 131 12- SEE ATTACHED SITE SKETCH The issuance of this permit by the Health Department in no way guarantees the issuanceeooT her 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.. The construction and installation requirements of Rules .1950, .1952, .1954, .1955, with the attached system layout. ISSUED T0: Construction Authorization (Required for Building Permit) .1956, .1951, .1958. and .1959 are incorporated by references into this permit and shall be met. Systems shall be installed in accordance PROPERTY LOCATION: ` �1Ris v6- r 1 SUBDIVISION ' l LOT # S� Facility Type: �m����0r'1 ❑ New "9 Expansion Basement? ❑ Yeses No Type of Wastewater System ** _ (See note below, if applicable ❑) L- Q-G-Q N (I (Repair) Installation Requirements /Conditions Number of trenches Septic Tank Size gallons Exact length of each trench r) 5 Pump Tank Size gallons Trenches shall be installed on contour at a Maximum Trench Depth of: IS (Trench bottoms shall be level to +/ -1/4" in all directions) Basement Fixtures? ❑ Yes -MNo ❑ Repair Pump Requirements: ft. TDH vs. GPM (Initial) Wastewater Flow: yl 0 GPD feet Trench Spacing: Feet on Center Soil Cover: inches inches (Maximum soil cover shall not exceed 36" above the trench bottom) Aggregate Depth: Conditions. I�r�n —15 o� flawt_�r�E `Td `%4E T--Nip ®� `1 Ile ,s-Sl�� G- -tom WATER LINES (INCLUDING IRRIGATION) MUST BE 10FT. FROM ANY PART OF SEPTIC SYSTEM OR REPAIR AREA. NO UTILITIES ALLOWED IN INITIAL OR REPAIR DRAIN FIELD AREA. inches below pipe inches above pipe inches total * *If applicable: / understand the system type speciTed is different from the type speciTed on the app lication. / accept the specifications of this permit. Owner /Legal Representative Signature: Date: This rnmtrnrfinn Authnri73tion is suhiect to revocation if the site Dian. plat or the intended use changes. The Construction Authorization shall not be transferred when there is a change in ownership of the site. This Construction Authorization Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH Authorized State Agent: ' Date: „ > )'I Constr ' Authorization Expiration Date: HTE# 3 -1 Q4L Permit # 2Q- l 1"'�15 Harnett County Department of Public Health Site Sketch ISSUED T0: Authorized S