IPACHTE#I Harnett County Department of Public Health 2 4 4 9 3
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: 2 217
_
ISSUED TO: r~ l MM t h SUBDIVISION ~i t mMer ( LOT #
I~d
NEW REPAIR ❑ EXPANS ON El Site Improvements required prior to Construction Authorization Issuance:
Type of Structure:
Proposed Wastewater System Type: -Z_rr
Projected Daily Flow: 3 Z GPD
Number of bedrooms: Number of Occupants: max
Basement ❑Yes 14 No
Pump Required: ❑Yes ❑ No )4Nay be required based on final location and elevations of facilities
Type of Water Supply: El Communi Public ❑ Well Distance from well O feet
n ~Permit valid for ~ five years
Fern tt conditions: IV 6 UM_~_1,Vi 1,, ~ jA (:vti.1 G2 0-'d
~C✓t y r-
f!J2 Lin M A-._ L _ . - _ tr Jz_ A El No expiration
Authorized State Agent: LAX I _ Date: 02 -a -,o y 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 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 .1950, .1951, .1954, .1955, .1956. .1957, AM. and .1959 are incorporated by references into this permit and shag be met, Systems shall be
installed in accordance with the attached system layout.
ISSUED TO: Y<Crync~Ga ctt mmrh~ -5 PROPERTY LOCATION: _1 Z 2
SUBDIVISION _ f (ty~m~2 ~q, c LOT
Facility Type: _ -)it 2/3a )a New ❑ Expansion ❑ Repair
Basement? ❑ Yes Sd_ No Basement Fixtures? ❑ Yes -L"~Nci
Type of Wastewater System** (Initial) Wastewater Flow:_ GPO
(See note below, if applicable 7
Instalation RequiraneOWCondit WIF (Repair)
Septic Tank Size 0:~)'3 gallons
Pump Tank Size gallons
Pump Requirements: ft. TDH vs.
Conditions:
Exact length of each trench ) , X J feet
Trenches shall be installed on contour at a
Maximum Trench Depth of: Q inches
(Trench bottoms shall be level to +1-114"
in all directions)
GPM
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: /understand the system type specified it different from the type specified on the app/ication. /accept the fpecifIcationr of this oetmit
Owner/Legal Representative
Date:
This Construction Authorization a 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 ATTACHED SITE SKETCH
Authorized State Agent: Date: ~L
Construction Authorization Expiration Date: 0 .c3lL d,2 3
HTE# OY-L ~y2 2- Permit # -J~ Y `1 3
HarTlett ('o'ulty DeVal "lent of hiblic Health
Site Sketch
PROPERTY LOCATON: Z 2 ~
ISSUED T0: ~~-(/►'!/~~I / SUBDIVISION W~')'1Mf~
u LOT #
Authorized State Agent
Date: _ P? d -
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