IPAC RRHTE#spa Harriett County Department of Publicea(th 2 5 5 0 5
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
J PROPERTY LOCATION: 112 r
ISSUED TO: SUBDIVISION S Q 7 a t~ k) LOT # S
NEW-;X REPAIR ❑ EXPANSI ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: 3- - - a
Proposed Wastewater System Type: M rt~ 2 s~,.
Projected Daily Flow: 36Z (~-^Y GPD
Number of bedrooms: 3 (VIC-t-it Number of Occupants: _ max
Basement ❑Yes -0-No
Pump Required-Aes ❑ No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community ublic ❑ Well Distance frorg well 103 feet Permit valid for. `?`Five years
Permit conditions: W & QAJ, C. y,, ( LA jo ~ ❑ No expiration
vIM U LO 'oru"v7
Authorized State Agent: Date: _0 S- 07 7' SEE ATTACHED SITE SKETCH
The issuance of this permit by th Health Department in no 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 a 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 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, .19% 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: l mf1 S J PROPERTY LOCATION:
_ SUBDIVISION 9 -CJ 7 041 v S LOT # /J-
facility Type: :iFn 3_ S 30 (Z- DZa- New ❑ Expansion ❑ Repair
Basement? ❑ Yes 5=No Basement Fixtures? ❑ Yes / No
Type of Wastewater System** f ~T f/u< <r>`~ (Initial) Wastewater Flow: GPD
(See note below, if applicable W
(Repair)
Installation Requirements/Conditions Number of trenches
Septic Tank Size I D Q_ gallons Exact length of each trench --J feet Trench Spacing: _ Feet on Center
Pump Tank Size gallons Trenches shall be installed on contour at a Soil Cover. inches
Maximum Trench Depth of: __1 J-.2 1_ inches (Maximum soil cover shall not exceed
(Trench bottoms shall be level to +/-1/4" 36" above the trench bottom)
in all directions)
Pump Requirements: ft. TDH vs. GPM inches below pipe
Aggregate Depth: inches above pipe
Conditions: inches total
**If applicable: l understand the system type specified is different /ram the type specified on the application. l accept the specifications of this permit.
Owner/Legal Representative Signature: Date:
This Construction Authorization is subject to revocation if the site Dlan. Dlat or the intended use rhanoas The Cmtrsirtm en hnrinrm~ Gnu nnr h. --fa..ve -6.,,, d....,, , d,.,,... f.. i
Construction Authorization is subject to compliance with the (p'rovisi~ons of the laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
At^ 1 Date: I S' d 06
Construction Authorization Expiration Date: 0~,-dn- 13
HTE# DJ ~b3d idd Permit # ~j 5-D S~
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Harnett c+ount`T Depailinent of 1"tiblic Health
Site Sketch
PROPERTY LO(ATON: p r
ISSUED TO: c
SUBDIVISION LOT # -Zj
Authorized State Agent: 9L Date: 7 L) 5 0G 3j
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