IPAC RHTE# 7l J CID- 1 an P- Harnett County Department of Public Health 2 5 5 0 8
Improvement Permit lze 4ccJ per,,-4- it?y65
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: ~ 1.3"'
ISSUED T0: kc(I r)c SUBDIVISION ,Sl~,izc LOT # ~t~
NEWJ R PAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: ~ ~ X 3l -
Proposed Wastewater System Type: 2 (44
Projected Daily Flow: 3 too GPD
Number of bedrooms: __3 A* Number of Occupants: G max
Basement []Yes 'i No
Pump Required: ❑Yes ❑ No1 May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community Public ❑ Well Distance from well I o.> feet Permit valid for. -,kt Five years
Permit conditions: 57LA9 O~ t'vt-,r%.-- ssk--, ~ \nv AA" G2 cl It",1 .-,r 1%'1 , tah,rc ❑ No expiration
W n - la L -lot-. ~ ~,-3 Ns- - e- r, Vcr ho n.., • t•N, 5 S lb u t%. (VI t c -f-- , n r s ~r
Authorized State Agent.: Date: 40 06- 'Z3 -0 SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health epartment inoo 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, .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 T0: t~ ~nclct~.~ t s~r~~'~rHp S PROPERTY LOCATION: Its
SUBDIVISION 1 ~d f~t, vcc LOT # 2ej
facility Type: F" New ❑ Expansion ❑ Repair
Basement? ❑ Yes No Basement Fixtures? ❑ Yes 11~;yN0
Type of Wastewater System** Sys (Initial) Wastewater Flow: (a3 GPD
(See note below, if applicable)
S c r J*r- (Repair)
Installation Requirements/conditions Number of trenc es
Septic Tank Size /22,3 gallons Exact length of each trench c _ feet
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of: d' d 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. G inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
Aggregate Depth:
inches below pipe
inches above pipe
inches total
*If applicable: / understood the system type specified if diNerent from the type specified on the app/ication. /accept the specifications o1 this permit
Owner/Legal Representative Signature: Date:
- •I- • J- - > , Ft-, pia, of we maoaeu use eoanges. ine construction Aumonzation snail not tie transferred when there is a change in ownership of the site. This
Construction Authorization is subject to co liance 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: Date: ~a
Construction Authorization Expiration Date: a 3 I'
HTE# Q VS JJ- Moa a- Permit # ~--rJ
Harnett County Department of Public Health
Site lk ketch
PROPERTY LO(ATON: I 1 a 1
ISSUED T0: SUBDIVISION pit G LOT #
Authorized State Agent: k Date: a J
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