IPACHTE#Q - 500- I J7 2 Harnett County Department of Public Health 2 4 6 5 7
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION:- 2 1
ISSUED TO: SUBDIVISION LtJ~ J~ 1 L• ~ c LOT # 1jj_
NEW
,46
- REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: 5 (70 1 {d ).1{ - ~-f 0 ex-
Proposed Wastewater System Type:
Projected Daily Flow: GPD
Number of bedrooms: Number of Occupants: __k_max
Basement ❑Yes o
Pump Required: ❑Yes ❑ No May be required based on final location and elevations of facilities
Type of Water Supply: ❑ (ommunity -~a' Public ❑ Well Distance from well ~J feet Permit valid for Wive years
Permit conditions: ] (U r~ - at'ri., 6,h 5, J { p~ 1 1_1 cj 2~v~,~c( (e vc ( pr- ~n fir- ❑ No expiration
Authorized State Agent: _ Date: 07-0 U SEE ATTACHED SITE SI(M
The issuance of this permit by 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 subfect to revocation it 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 taws 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, .1957, .1954, .1955. .1956, 1957, .1959. and .1959 are incorporated by references into this permit and shall be met Systems shall be
installed is accordance with the attached s tem layout.
ISSUED T0: _0A Irlt t) PROPERTY LOCATION: Z
SUBDIVISION ~ '0 / /k LOT # ~
Facility Type: SI-New ❑ Expansion ❑ Repair
Basement? ❑ Yes r
~Zj_. No Basement fixtures? ❑ Yes ci4-No
Type of Wastewater System" _ nitial) Wastewater Flow v GPD
(See note below, if applicabl 4 'r n
2.T l t p c r Stiff t (Repair)
InsUllation Aequirements/Condi6m
Septic Tank Size 00- gallons Exact length of each trench f-`=--- feet Trench Spacing / Feet on Center
Pump Tank Size gaAons Trenches shah be installed on Comm at Suit Cover. inches
Maximum Trench Depth of: d 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
Conditions: Aggregate Depth: inches above pipe
inches total
"If applicable: / understand the system type specified is different from the type speciCed on the application. / accept the specilcations of this permit.
Owner/Legal Representative Signature: Date:
This (onstruction Authorisation 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 Au7nR= and Rules for Sewage Treatment and Disposal and to the conditions of this permit.
SEE ATTACHED SITE SKETCH
Authorized State Agent: Date: _t./.3 Lf
thorization Expiration Date: -6 0 y- 4013
HTE# 0 153D Z Permit # ~}r ~ W
Harnett County Department of I'~ihl icy Health
Site Sketch
Liz,-.J PROPERTY LOUTON: 112 S
ISSUED T0: ~i i'\cl1 SUBDIVISION C✓1.2~c f LOT #
Authorized State Agent: 'r Date: _o
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