IPACHTE#_(?g' Harnett County Department of Public Health 2 4 4 9 2
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
L PROPERTY LOCATION: f ~J lff
ISSUED TO: Cum %'t Uoik-s manivtunu y\ . 1. t I _ _ _ _ 1 t _ UL711
NEW' REPAIR El EXPANSION El Site Improvements required prior to Construction Authorization Issuance: v
Type of Structure: gro - 5V r = D
Proposed Wastewater System Type: d-
134-
Projected Daily Flow: L GPD
Number of bedrooms: Number of Occupants: max
Basement ❑Yes AAo
Pump Required: ❑Yes ❑ No .-May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community Public ❑ Well Distance from well
n feet Permit valid for. "Five years
Pe tt conditions: All U~ 1' is ~ L,k c...l I C,-,. ( I,.~, ~ L" - ❑ No expiration
Authorized State Agent: Date: Z r' 10 % 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 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 a 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 1950, .1952, .1954, .1955, .1956, .1957, .I95& and .1959 are incorporated by references into this permit and shall be met. Systems shall be
installed in accordance with the atpa(hed system I yo
ISSUED TO: Aft4/kb~- ~ yt t/ PROPERTY LOCATION: 3
SUBDIVISION y kji ~ rsc ) ► • LOT #
Facility Type: Sco -S6 y -37n ~ New ❑ Expansion ❑ Repair
Basement? ❑ Yes 50o Basement Fixtures? ❑ Yes iZNo
Type of Wastewater System* t.~(Initial) Wastewater flow.3_L3 GPD
S 6e1 'f
( ee note ow, t applicable
(Repair)
InswWon %igirerttents/fondi6ons
Septic Tank Size gallons
Pump Tank Size gallons
Pump Requirements: ft. TDH vs.
Exact length of each trench I) k.\ J feet
Trenches shall be installed on contour at a
Maximum Trench Depth of- A 3:zR inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
GPM
Trench Spacing: 0 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
Conditions:
""N applicable: / understand the system type specified is different from the type specified on the app/icatlon. / accept the specircavons of this permit.
Owner/Legal Representative Signature: Date:
This Construction Authorization is subject to revocation if the site plan, plat, or the intended use channes. The fnnstnictinn Authnrintmn chit not k- t.,"de '-A W6,... ,i,...
. ,.o..b.. "'.'„M
o the site. This Construction Aut n 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 Agen . V Date: C,>? - S "
Construction Authorization Expiration Date: Oda- 122Q13
HTE# Ub' ~-I` Permit # cggYjZ
Harnett County Department of hiblic Health
Site Sketch
! PROPERTY LOCATON: J Y
ISSUED TO: (l1 I A,~ ~t1 SUBDIVISION N, LOT #
Authorized State Agent Date: n 2=~C-0
1n
F
t tij of-~4cr J~lc J~9wn
J,,,, L, a CDL, r ~