IPACHTE#- Harnett County Department of Public Health 2 4 4 9 9
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
( ( PROPERTI LOCATION: 112
ISSUED TO: Q~' V~ -N j ) C SC ` - SUBDIVISION k J0A S LN, Y--c LOT # cJ
NEW 'O REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: J rr> y g X tC is _
Proposed Wastewater System Type: 2 0- t K d 4-. t t
Projected Daily Flow: GPD
Number of bedrooms: Number of Occupants:. max
Basement ❑Yes V No
Pump Require&AYes ❑ No ❑ May be required based on final location and elevations of facilities
Type of Water Suppy. ❑ Community ,E4 Public ❑ Well Distance from well feet Permit valid for. *f five years
Permit conditions: l m c{ vre t t A-t ❑ No expiration
Authorized State Agent: q Date: SEE ATTACHED SITE SKETCH
The issuance of this pennit by a 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 4 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, .1952, .1954, .1955, .1956, .1957, .1958. and .1959 are incorporated by references into this permit and shall be met. Systems shall be
installed in acco a with the attached system layout
ISSUED TO: V1 ,1r s-~c~ PROPERTY LOCATION: 2 t
SUBDIVISION , ( S h , t LOT #
Facility Type: t (~51~~{ Y 14 New ❑ Expansion ❑ Repair
Basement? ❑ Yes 9 No Basement fixtures? ❑ Yes J~J No
Type of Wastewater System** j_ W,j. , ► , > s (Initial) Wastewater Flow- 1) GIRD
(See note below, if applicable lJ
t~'t~ - t fr (Repair)
losWbf*n Itequimttetrts/Conditwns
Septic Tank Sized gallons Exact length of each trenchfeet
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of. f I ) 4 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 Cover. L- inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
inches below pipe
Aggregate Depth: inches above pipe
inches total
"If applicable : l underfUnd the system type specifed is different from the type specified on the application. l accept the specifications of this permit.
Owner/Legal Representative Signature: Date:
,nu wn~uvuiw~ -11VU4Uw D )uutGU W 1VTMdtj00 11 me site plan, prat, or the mtenaea use changes. the construction Authorization shall not be transferred when there is a change in ownership
of the site. This Construction Authorization is 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: ~d Date: +J 7
Construction Authorization Expiration Date:
HTE # 0 ~ ~ 1 `t 3 ( Permit # 044 ~ `j
HrtrllPtt County I epaitment of hiblic Health
Sitv Sketch
PROPERTY LOCATON: I I Z I
ISSUED T0: C ► SUBDIVISION C~%d ~d l L. LOT # i
Authorized State Agent: Date: O J 33
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