IPACHTE#_Qgi11360 Harnett County Department of Public Health 2 4 4 9 a
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
ISSUED aim 6J PROPERTY LOCATION:- I I t f
T0: J _ SUBDIVISION l.J of JrLt_ LOT # J; 4
NEW 7' REPAIR D EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: _ o - 3 L~ 3 Q2
Proposed Wastewater System Type: 2fl- a , ,~~w_
Projected Daily flow: ~ j,0 ` GPD
Number of bedrooms: 3 Number of Occupants: __~_max
Basement []Yes t~fto
Pump Required: Dyes El No '~101ay be required based on final location and elevations of faclities
Type of Water Supply: ❑ Community 19 Public ❑ Well Distance from well
feet Permit valid for. Li4~ Five years
Permit conditions:~i,s ❑ No expiration
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Authorized State Agent: . ~ - Date: 0 2 - Z -J 1(1, SEE ATTACHED SITE SWCH
The issuance of this permit by 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 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 forB_uilding Permit
The construction and installation requirements of Rules 1950, .1951, AM, AM, .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: d P>,._, J PROPERTY LOCATION: _ j 12 5
SUBDIVISION W"cld S , rc LOT # 2I
Facility Type: Sb ~t "3L - rx- ,S- New ❑ Expansion ❑ Repair
Basement? ❑ Yes -&~No Basement Fixtures? El Yes 6i~:hlo
Type of Wastewater System** _2f y- 4A-L.- ~ j, (Initial) Wastewater Flow: 3 L GPD
(See note below, if applicable Q)
Insuhfgn Requirwettt cwd -L-Pe (Repair)
idons
Septic Tank Size 1 J gallons Exact length of each trench s feet
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of: a y inches
(fren(h bottoms shall be level to +/_1/4"
in all directions)
Pump Requirements: ft. TON vs. GPM
Conditions:
Trench Spacing: feet on Center
Soil Cover. inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
Aggregate Depth:
inches below pipe
inches above pipe
inches total
"If applicable: / Undeatand the system type specified it different from the type pacified on the app/icatinn. /accept the rpeci6cations of this permit.
Owner/legal Representative Signature:-- Date:
This Construction Authonzation 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
SEE ATTKNED SITE SWO
Authorized State Agent. Date: (1 2 21 J 15'
Construction Authorization Expiration Date: U ? ' t r 0~% 3
HTE# Permit # f `f `I J
Harnett County I epatiltient of p'nblic Health
Site Sketch
ISSUED T0: cq M ~cr ran o PROPERTY LOCATON: ~ ~J
` SUBDIVISION LOT #
Authorized State Agent ✓ Date: - z l -~tS
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