IPACHTE# x-r30-3g~ Harnett County Department of Public Health 24491
Improvement Permit
A building permit cannot be issued with only an Improvement Permit Wdj `l PROPERTY LOCATfON:_ C a 7
ISSUED T0: _ C*iiT-+ j ~LcG) _ SUBDIVISION _ a --`t - _ LOT # [ V/101 NEW)(J REPAIR ❑ EXPANSION ❑ Site Improvements required prior Construction Authorization Issuance:
Type of Structure: _ Fly- S(A 3 32
Proposed Wastewater System Type: Z
Projected Daily Flow: 3(. _ GPD
Number of bedrooms:Number of Occupants: + max
Basement ❑Yes {W No
Pump Required: ❑Yes ❑ No May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community j4- Public ❑ Well Distance from well ~-o feet Permit valid for. -,)Rl Five years
Permit conditions: pnt F' A Let„' r n-'A 'A'.,~~ mot` ~ ~s
S7i.tC~ in -:k- uk'- ~ t t t t ❑ No expiration
Authorized State Agent: -f Date: SEE ATTACHED SITE SKETCH
The issuance of this permit by the ealth 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 d 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 Laws 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 .19SD, .1952. .1954, AM, .1956, .1951, .1958. and .19S9 are incorporated by references into this permit and shall be met. Systems shall be
installed in accordjnq with the attache system layout, A
ISSUED TO: Ne tn~.~,-~ J,Cr n PROPERTY LOCATION:
SUBDIVISION U c A c LOT # ~i
Facility Type: $Z-- New ❑ Expansion ❑ Repair
Basement? ❑ Yes No Basement Fixtures? ❑ Yes3 No
Type of Wastewater System" _ 2,f 3 s (Initial) Wastewater flow, 317 GPD
(See note below, if applicable
Inmbtion ReguinyttetsttlCmd 0 (Repair)
itions
Septic Tank Size 3'Z) gallons Exact length of each trench Jz) feet
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of. inches
(Trench bottoms shall be level to +/_114"
in all directions)
Pump Requirements: fL TDH vs. GPM
Conditions:
Trench Spacing feet on Center
Soil Cover inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
inches below pipe
Aggregate Depth: inches above pipe
_ inches total
**If applicable:
/ nndeatand the syrtem type specifed is different from the type specified on the application. l accept the specifications of this permrt
Owner/Legal Representative Signature: Date:
-
This Construction Authorizatan is subject to revocation if the site plan, plat, ar the intended use changes. The Canstruction 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 ATTACHED SITE SKETCH
Authorized State Agent: I Date: 3
Construction Authorization Expiration Date: 0 L '2j-' :~J1
HTE# 0~-1 ~ I5 3y Permit # ,,9 y y 1 /
Harriett County Department of MIblic Healtll
Site Sketch
LOT #
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