IPAC RHTE#-A:~ -s=aQ,3ci HarneLL County Department of Public Lalth 2 4 5 7 7
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATIQG 5 / ~l~ C . r; 1
ISSUED TO: b ti. Tb r o Kef C . SUBDIVISION f-c t'~J 7'/0 •~s LOT #
NEW a- c REPAIR ❑ 10 , EXPANSION Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: t` ' ye - -b t"`
Proposed Wastewater System Type: c2S7- cse.
Projected Daily Flow: ,3`o (3 GPD
Number of bedrooms: ,3 Number of Occupants: max
Basement ❑Yes F "No
Pump Required: ❑Yes ❑ No W"Ma~ required based on final location and elevations of facilities
Type of Water Supply: ❑ Community I Public ❑ Well Distance from well /w feet Permit valid for.
Permit conditions:
5J-five years
❑ No expiration
Authorized State Agenr Date: -7 SEE ATTACHED SITE SKETCH
The issuance of this pe y the Health Departme m 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 9 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 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, .
installed in accordance with tJ atta~ed systgm layout.
ISSUED TO: ot-- o~ ~ J~ 1-tc
Facility Type: L~-New
Basement? ❑ Yes Po Basement Fixtures? ❑ Yes
Type of Wastewater System**
(See note below if applicable
956, .1957, .1958. and .1959 are incorporated by references into this permit and shall be met. Systems shall be
PROPERTY LO(ATION: J-X //,/Z
SUBDIVISION t ;;.,I- -,k 1j' LOT #
i! 2
❑ Expansion ❑ Repair
❑ No
Olt ra Wastewater Flow: t* GPD
o2S"ra /~c~c,c,,_S tau (Repair)
InsWVon R quirements/Conditiom
Septic Tank Size ' /60'0 gallons
Pump Tank Size gallons
Pump Requirements: ft. TDH vs.
Exact length of each trench '7 X Ro feet
Trenches shall be installed on contour at a
Maximum Trench Depth of: inches . /45 (Trench bottoms shall be level to +/-1/4"
in all directions)
GPM
Condi ns: ` r-":.,k - kqj- -~-4 i. &.,),N
c
C
Trench Spacing '9 feet on Center
Soil Cover. L inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
inches below pipe
Aggregate Depth: inches above pipe
/ a ; J,,, inches total
'*If applicable: / undeatand the syrtem type speciled is different from the type specified on the app/ication. / accept the specifications 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 be transferred when there is a change in ownership
of the site. This Construction Authori ' s Nect to compliance with the provisions of the laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit.
SEE ATTACHED SKETCH
Authorized State Agen Date: /2~°~
Construction Authorization Expiration Date: 2 A
f c
HTE# OT-J' a C0 cJ l ~ Permit #
Harnett County I-)epallnlent of hiblic Health
Site Sketch
.
PROPERTY LoCaTON:.l`/ V~2 C- ~ ~ s~-•.~-~.- : t # ,e~
ISSUED TO: C~~Tdr~~ ~'l f SUBDIVISION LOT #
Authorized State Agent:- Date: `7 - 12-0
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