IPACHTE#_+J OD- u (c Harnett County Department of Public Health 2 4 4 6 3
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
ISSUED TO: S~A~~ PROPERTY LOCATION: I\
SUBDIVISION A LOT # Z
NEW REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: (h d 8 )1 S Z -
Proposed Wastewater System Type:
Projected Daily Flow: ^ Gpp
Number of bedrooms: Number of Occupants: (e max
Basement ❑Yes No
Pump Required: f*S ❑ No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community rX, Public ~ Well Distance from well ~~T~feet Permit valid for. Five years
Permit conditions: ~ n s c f~~v'A A\\ c, -it gut k i _ ❑ No expiration
Authorized State Agent: - L Date: 01- ~3 1- C) ~c SEE ATTACHED SITE SKETCH
The issuance of this permit by t 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 so ject 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 Caws 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, .I 95S, A 956, .1 9S7, .1958. and .1959 are incorporated by references into this permit and shag be met. Systems shall be
installed in accor with the attached sys m la out
ISSUED TO: ~n ~12 an S PROPERTY LOCATION:
SUBDIVISION AIC $ LOT # Zr
Facility Type: C)9X 2 New ❑ Expansion ❑ Repair
Basement? ❑ Yes ~ N Basement Fixtures? ❑ Yes ~ No
Type of Wastewater System'* V rt n - fzav~\ (Initial) Wastewater flow- _ GPD
(See note below, if applicable O)
Repair)
Inshhta ReUnrients/Conditions
Septic Tank Size ,_Jon_ gallons Exact length of each trench _ Y feet Trench Spacing: 3 feet on Center
Pump Tank Size A o,--> gallons Trenches shall be installed on contour at a Soil Cover. inches
Maximum Trench Depth of- I 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
**I applicable: l undeatmd the system type Jpeci>!ed is different from the type rpecifled on the app/ication. / accept the speciAcationr of this permit.
Owner/Legal Representative Signature: Date:
Th? r.. t...l.. ..L:-
- - .,..,r.,, a¢ J-" inu, of me mienuea use cnanges. ine construction Autnorwnon Shan not be transferred when there is a change in ownership
of the site. This Construction Authorization is subject to compliance with the provisions of the taws and Rules for Sewage Treatment and Disposal and to the conditions of this permit
SEE ATTACHED SITE SKETCH
Authorized State Agent: Date: a I a ) - ~
Construction Authorization Expiration Dater i- 1 ) a Ol'3
HTE# 0 C4 - S-J-l- L 4a t°t Permit # ~)~l ~°.3
Harnett County Department of Miblic Health
Site Sketch
\ PROPERTY LOCATON: ?S
ISSUED TO: k4 W n i b ~y~ J SUBDIVISION C n- LOT #
Authorized State Agent } Date: J
p4