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IPAC RHTE# -U 6 -5.~3 R. HarneIl County Department of Public h~talth 2 4 9 3 2 `Vaa~o~ Improvement Permit eat A building permit cannot be issued with only an Improvement Permit PROPERTY LOCATION: Q -4Us5 \t~., L tiC~wT Qo ISSUED TO: C-10 N11Z_-otx~ ~Oc~ES SUBDIVISION ~a~s~~~zos L,s LOT # NEW REPAI PANSION ❑ Site Improvements required prior to Construction Authorization Issuance: Type of Structure: `3 F 9 9~ 1 K y Proposed Wastewater System Type: ~~'"lo 6sw~~O iv Sys~G~ po "e Projected Daily flow: 1 GPD Number of bedrooms: 3 Number of Occupants: max Basement ❑Yes X No Pump Required: ❑Yes ❑ No X May be required based on final location and elevations of facilities Type of Water Supply: ❑ Community -X Public ❑ Well Distance from well \ 0 feet Permit conditions: Permit valid for. XFive years ❑ No expiration Authorized State Agent:: Q The issuance of this permit by the Health Department in no way guarantees the usuan 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: 11,5` 3, SEE ATTACHED SITE SKETCH other permits. The permit holder is responsible for checking with appropriate governing bodies in meeting their requirements. This nle hermit 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: C-0 - --C3 Q'< PROPERTY LOCATION: SUBDIVISION ~~czp s LS LOT # 10 Facility Type: New ❑ Expansion ❑ Repair Basement? ❑ Yes No Basement Fixtures? ❑ Yes No Type of Wastewater System* 2S"(o RGou~ ~~0 tt Sys; P~ n,P (Initial) Wastewater Flow: GPD (See note below, if applicable Installation Requirements/Conditions Septic Tank Size 1 CD b c7 gallons Pump Tank Size I no© gallons Pump Requirements: ft. TDH vs. Conditions: ~I~.. 1-\,ouSE S t--r, f O F 1-\ou-~'z-_. QL- Number of trenches - Exact length of each trench a feet Trenches shall be installed on contour at a Maximum Trench Depth of. I'-i inches (Trench bottoms shall be level to +/-1/4" in all directions) GPM A~f ~"oW-J Trench Spacing: 1 Feet on Center Soil Cover. S a inches (Maximum soil cover shall not exceed 36" above the trench bottom) inches below pipe Aggregate Depth: inches above pipe ^T-- 's: inches total `If applicable: l understand the system type specified is dih`erent from the type specified on the application. / accept the specilcations of this permit. Owner/Legal Representative Signature: Date: This Construction Authorization is subject to revocatreA the site plan, 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 is subject to compliancelr>~th~---wfsieu the laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH Authorized State Agent: n Date: 7 Conston Authorization Expiration Date: - i HTE# Cam- S - a0D-015 Permit # aA`131 Harnett County Department of Pliblic Health Site Sketch PROPERTY LOCATON: C-)ci, \P~N L ~ti~c ISSUED TO: CdMF0C1. SUBDIVISION ~dcte s~ \2A1 LOT # Authorized State Agent Q-'S oL-\v S~ZrCO Date: 'I I \5 G~' t t1" t1`>S ~ AAA ~ 46 ~ n► C trv OE5 p Ec_aC ~ s R E V F7 g r 11'l r '~1~5Mt~ U CAv (r:~