IPACHTE# i IiQ 53 Harnett County Department of Public Health 2 4 4 9 6
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
~~33 PROPERTY LOCATI I t 21
ISSUED TOOP Vt N V SUBDIVISION _..(Z--J 7 y LOT # I L
NEW V-- REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: - Sf a It-
Proposed Wastewater Sys em Type: f. 2f~1d-~
Projected Daily Flow: -a GPD
Number of bedrooms: Y Number of Occupants: max
Basement ❑Yes Jam'` No
Pump Required-,44-yes ❑ No ❑ May be required based on final location and elevations of facilities
Type of Water Supply. ❑ C mmunity 5 P lic -Well Distance from well feet Permit valid for. Five years
Permit con bons: n2c( Dnt r` t , AA le, ❑ No expiration
Authorized State Agent: - ~ Date: _ 02 -a&-~ Y SEE ATTACHED SITE SKETCH
The issuance of this permit by fTealth 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 Buildine Permit
The construction and installation requirements of Rules .1950, AM, .1954, .1955, .1956. .1951, .1953. and .1959 are incorporated by references into this permit and shall be met. Systems shall be
installed in accordance with the attached system layout. f
ISSUED TO: C`pv~V- t I J Lr-y~~ 1 PROPERTY LOCATION: Z
SUBDIVISION 02e) 7 OP r J LOT # tr
Facility Type: t{~ x t?t'L IK- New ❑ Expansion ❑ Repair
Basement? ❑ Yes [J-,,~No Basement Fixtures? ❑ Yes 9 No
Type of Wastewater System" -t 21-', d- j~ji.(Initial) Wastewater Flow- Y GPD
(See note below, if applicable
LX 0 (Repair)
Installation %luireants/conditions
Septic Tank Size -'J gallons Exact length of each trench] feet
Pump Tank Size ~t2 J gallons Trenches shall be installed on contour at a
Maximum Trench Depth of: Ig 3.A_ inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
Pump Requirements: ft. TDH vs. GPM
Conditions:
Trench Spacing: Feet on Center
Soil (over. inches
(Maximum soil cover shalt not exceed
36" above the trench bottom)
Aggregate Depth:
inches below pipe
inches above pipe
inches total
"'1f applicable : l undersm#d the system type specified is different from the type specified on the application. l accept the specifications of this permit
Owner/legal Representative Signature: Date:
wuouu~um~ numvnuuun i> >uyeu iu ierucatwn n me sue plan, piat, or the mtenoea use changes. Me 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: 0 L- 2 ~ '3y
Construction Authorization Expiration Date: 4i - l l - as ) 3
HTE O i - 23- N` 3 Permit # ;y q ~ C
Harnett County IepailmPnt of hiblic Health
Site Sketch
PROPERTY LOCATON:-_ I M 21
ISSUED TO: CaIJ,vv 1 f L ,~t SUBDIVISION a(u) 7 of*l LOT # / f L
Autho6zed State Agent: Date:
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