IPACHTE# /1 Harnett County Department of Public Health 2 4 4 4 5
Improvement Permit
rKUYtnlr LUTAIIUN:_)//`f6J CA:)
ISSUED T0:~eL/ UrDIz SUBDIVISION - T'o/~ i3 Tu/»iC LOT #
NEW W PAIR S~~ EXPANSION 0 Site Improvements required prior to Construction Authorization Issuance:
Type of Structure:
Proposed Wastewater System Type:
Projected Daily Flow: -)(10 GPD
Number of bedrooms: Number of Occupants: max
Basement ❑Yes 21o
_
Pump Required: ❑Yes ❑ No MMa required b don final location and elevations of facilities
Type of Water Supply: ❑ Community 1~ Public Well Distance from well /Qd feet Permit valid for. f~ Five years
Permit conditions. _ ❑ No expiration
Authorized State A Date: -0 SEE ATTACHED SITE SKETCH The issuance of this Perim y !e 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 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 taws and Rules for Sewage Treatment and Disposal and to (ondkions of this permit.
Construction Authorization
(Required for Building Permit)
The construction and installation requirements of Rules .1950, A952, .1954, .1955, .1956, A951, .1958, and .1959 are incorporated by references into this permit and shall be ntet. Systems shall be
installed in accordant with The attached system layout.
ISSUED TO: ~jtIZS/ 6* 1Ke z&, 7-a,4y~z PROPERTY LOCATION: Ve)3 e5b /<4'
SUBDIVISION _ _04 0 & IVa r LOT #
facility Type: I2 New EjAxpansion El Repair
Basement? 11 Yes 2"No Basement fixtures? El Yes No
Type of Wastewater System** ZS%,ZEI~tp}J.;~~ (Initial) Wastewater flow: 3_ GPD
A building permit cannot be issued with only an Improvement Permit
(See note below, if applicable
Za (Repair)
Insalb ioa Aequinanentx/Condi6om
Septic Tank Size ID00 gallons
Pump Tank Size gallons
Pump Requirements: ft. TDH vs.
Exact length of each trench _7-_ feet
Trenches shall be installed on contour all: a
Maximum Trench Depth of: inches
(Trench bottoms shall be level to,,+/-I
in all directions) 3~
GPM
Trench Spacing feet on Center
Soil Cover. inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
Conditions:
Aggregate Depth:
6 inches below pipe
o? inches above pipe
/Z inches total
**If applicable: ! Understand the system type specifed it different from the type specified on the app/ication. /accept the sped(cations of Chi 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 Authorization is subject to compliance with the provisions of the laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit.
Authorized State Age ,62 Date: 2-6 -09 SEE ATTACHED SITE SKETCH
Construction Authorization Expiration Date: 2.- ~-13
HTE# nY-5" I ?/-5V
Permit # --2 / Y y s
Harnett County Department of hibl is Health
Site Sketch
PROPERTY LOUITON:~/ yO F t fo/~5~ri,~ l
ISSUED TO: SUBDIVISION ~7"PI:E ZZ LOT #
Authorized State Age Date: Z - to O
~e~it,
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