IPAC RRHTE#cM--S--JCS':r)iWQ- Harnett County Department of Public Health 2 5 3 3 5
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: C.cL~r-svtt.>~ C-A-Wo.C-11 91D
ISSUED TO: ~~.r,1 t✓y `tv v~.~~ N i S SUBDIVISION 'Sr,-~t L~ O D,X LOT # _ A
NEW REPAIR 11 EXPA~SION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: W '5
Proposed Wastewater System Type: Z.S%P,,Eo-G NON
Projected Daily Flow: Li:~a GPD
Number of bedrooms: L'Il Number of Occupants: max
Basement ❑Yes No
Pump Required: ❑Yes ❑ No '~KMay be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community Public ❑ Well Distance from well l4Z) feet Permit valid for Five years
Permit conditions: ❑ No expiration
Authorized State Agent.: Q-r- Date: CI SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the isms other permits. The permit holder is resp nsible 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, .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: ~a.K,it. J `~yv "Ct 5 PROPERTY LOCATION: t~4vs,~E_ CVmrG \
r~ SUBDIVISION ~A~LN ~ ~Ay
.5 LOT #
Facility Type: Sii 0 ~1 'WSJ New ❑ Expansion ❑ Repair
Basement? ❑ Yes No Basement Fixtures? ❑ Yes XNo
Type of Wastewater System' a 5°Ia RGaUG'C\ o hl S-y6-NEM (Initial) Wastewater Flow: 4Z0 GPD
(See note below, if applicable
°/o ~LOIzC,<lc~>v Sys~~~n (Repair)
Installation Requirements/Conditions Number of trenches 3
Septic Tank Size S oe>p gallons Exact length of each trench feet
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of. 1%-\,k inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
Pump Requirements: ft. TDH vs. GPM
Trench Spacing: Feet on Center
Soil Cover: CD inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
Aggregate Depth:
Conditions: MtN►Meaen 0C G't eF coy&t+- svt_ezc ovt~-- 9aA NoF &-Ly
inches below pipe
inches above pipe
inches total
**If aolicable: l understand the system type specified it different from the type ,specified on the application. l accept the specifications of this permit.
Owner/legal Representative Signature: Date:
This Construction Authorization is subject to ca site 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 s compliance he ws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent:
Date: 6
Construc~y Authorization Expiration Date: C-
NTE # CSC,' 1 b Q(L Permit # x5335
Harnett County Depaxtinent of M blic Health
Site Sketch
PROPERTY LOCATON: ~-~SV~y~ Gavclxl~,
ISSUED T0:P.c~~Ly 1~vvLa~r~~~.rS SUBDIVISION Sa,►~tN ~0~5 LOT # 3
Authorized State Agent: ~Qy~vCri-'YaLxaoot~ Date: 4(-.1516
to~ DcLP.1~va,~E D~YG4'1
aS' ' s E-Sep cy
C5 xc-l.
~.SJ
D I
R
36'
a..S% REDUG~\o~v
2 E Po»a ~A n~