IPAC RRHTE#a%-s --JC91 nP-Q. Harnett County Department of Public Health 2 5 3 3 4
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: ~L:C~CSV SLL.C' GivcLC-rN V-V
ISSUED TO: l^tvGSN yNe-V5 SUBDIVISION Seyl-~1y O A LOT # -~k,_
NEWA REPAIR ❑ EXPISION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: '>q:0 Proposed Wastewater System Type: ~)L-G'%6 2EOuc7, kn N S ysyL.r%
Projected Daily Flow: L'1'o O GPD
Number of bedrooms: t-F Number of Occupants: 06 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 J°+ Public [I Well Distance from well '`OO feet Permit valid for. Five years
Permit conditions: ❑ No expiration
Authorized State Agent: Date: C J-) ) 63 1 SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the issuance er 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 ermit shall not be affected by a change in ownership of the site. This permit is subject to compliance with the provisions of
the taws 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.
ISSUED TO: 1wvEy-1 n(;-,r,;5 PROPERTY LOCATION: C~~cics~su.Q GWQX-A 9D
SUBDIVISION LNN O K.Z LOT # a.
Facility Type: 5 V-7Q As-1 New ❑ Expansion ❑ Repair
Basement? ❑ Yes No Basement Fixtures? ❑ Yes Ijk No
Type of Wastewater System** arj% Rv-'~U`-"O N S y 5N E,(Initial) Wastewater Flow: Ra _ GPD
(See note below, if applicable
3.50)6 QEZ005'\0 N S`)5"CEM (Repair)
Installation Requirements/Conditions Number of trenches _a
Septic Tank Size i oo 0 gallons Exact length of each trench 90 feet
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of. inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
Pump Requirements: ft. TDH vs. GPM
Conditions:
Trench Spacing: 01Feet on Center
Soil Cover inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
Aggregate Depth:
inches below pipe
inches above pipe
inches total
**If applicable: l understand the ryrtem type specified is different from the type specified an the application. l accept the rpecificationf 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 he trancforrod when thorn is a rhonuo in nwnarehin nf tho dte n,i<
Construction Authorization is subject m fiance 'th the v' ns o ws and Rules for Sewage Treatment and Disposal and to the conditions of this permit. SEE ATTACHED SITE SKETCH
Authorized State Date:
Constru Authorization Expiration Date: ti
HTE# Permit # a 533}
Harnett County Department of 1-~lblic Health
site slietch
PROPERTY LOCATON: C.e.-i1sv I "F- CA un c,,1 Qty
ISSUED T0: c+1.ti~ 1~~!C~~r.E S SUBDIVISION ~{+Yt1N OAxS LOT # a
Authorized State Agent: ~'~t `soLfla2~ Date: 6a~
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