IPAC RHTE#_b`)- S 3,) iI qD F- Harhttt County Department of Public mealth 23919
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: 3
ISSUED TO: c ► C cl~l SUBDIVISION c f a vss , } LOT tt `R -7
NEW jA REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: - 49 t 3 `j 3 0 2
Proposed Wastewater System Type: 2f"I-1/1 P
Projected Daily Flow: GPD
Number of bedrooms: Number of Occupants: -(,--max
Basement ❑Yes `Z No
Pump Required: ❑Yes `0 No ❑ May be required based on final location and elevations of facilities
Type of Water Suppl : ❑ Community [ Public ❑ Well Distance from well S J feet Permit valid for: Five years
Permit conditions: ~f c.a wv-
t C ~~w c ❑ No expiration
Authorized State Agent: r~t/
Date: - 02 SEE ATTACHED SITE SKETCH
The issuance of this permit Nth 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 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, .1952, .19 41 .1955 .1956 1957 .1958. and .1959 are incorporated by references into this permit and shall be met. Systems shall be
installed in accor nce with the attached system layout.
ISSUED TO: 1 C PROPERTY LOCATION:
SUBDIVISION r k ~o~r } a,{OT #
Facility Type: - k4Y Y 3 ~ New ❑ Expansion Repair
Basement? ❑ Yes *~f No Basement Fixtures? ❑ Yes -b"o
Type of Wastewater System" _ ai i. ~ , z~ t s }tom (Initial) Wastewater Flow: GPD
(See note below, if applicable
L F T 1-Q (Repair)
Installation Regairmwnts/Conditions
Septic Tank Size 0o0 gallons Exact length of each trench X feet Trench Spacing: Feet on Center
Pump Tank Site gallons Trenches shall be installed on contour at a Soil Cover. G inches
Maximum Trench Depth of: J I AA inches (Maximum soil cover shall not exceed
(Trench bottoms shall be level to +/-1/4" 36" above the trench bottom)
in all directions)
Pump Requirements: ft. TDH vs. GPM inches below pipe
Aggregate Depth: inches above pipe
(onditions:
inches total
*if applicable: /understand the system type speciCed it different from the type speaped on the app/ication, / accept the specifIcations of this permit.
Owner/Legal Representative Signature: Date:
This Construction Authorization is 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: D)- 14
Construction Authorization Expiration Date: - - 2.2 / 2 0 L I Y - d D
HTE# 1~ 3 ~ (Z- Permit # 3 5 ) )
Harnett County Department of Public Health
Site ketch
``few t PROPERTY LO(ATON: I I
ISSUED TO: - _ z`^~-- SUBDIVISION PA LOT # g ~
Authorized S
WL, Agent Date: 0 2 -
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