IPACHTE# Harnett County Department of Public Health
25890
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
n PROPERTY LOCATION: H -I-) a~
ISSUED TO: K r^ ~CZ \ C ?~Aoc"f 1 ` SUBDIVISION 7-:, N ~Er.1 Qo t r Tf- LOT #
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NEW L REPAIR l~ EXP ON ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: SC~9 (LA k5 3
Proposed Wastewater System Type: 'QzOU clC ~t7 N ~Y,5\ r~
Projected Daily flow: GPD
Number of bedrooms: Number of Occupants: max
Basement ❑Yes -X No
Pump Required: ❑Yes No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community X Public ❑ Well Distance from well ~O(1) feet Permit valid for. Five years
Permit cotidmons . ❑ No expiration
Authorized State Agent::
The issuance of this permit by the Health Department in no way guarantees the issuance o e
site is subject to revocation if the site plan, plat, or the intended use changes. The Improvement
the Laws and Rules for Sewage Treatment and Disposal and to conditions of this permit..
Date: aI --11-4 IrD SEE ATTACHED SITE SKETCH
permits. The permit holder is responsible for checking with appropriate governing bodies in meeting their requirements. This
ermit shall not be affected by a change in ownership of the site. This permit is subject to compliance with the provisions of
Construction Authorization
(Required for Building Permit)
The construction and installation requirements of Rules .1950, .1951, .1954, .1955, AM, .1951, .1958. and .1959 are incorporated by references into this permit and shall be met. Systems shall be installed in accordance
with the attached system layout.
ISSUED T0: ~r^En ~U tJ ~lo`~`~-St`s 1\~ PROPERTY LOCATION: w-i r~~
SUBDIVISION S s N 90 ) N1& LOT # S 1 a
Facility Type: New ❑ Expansion ❑ Repair
Basement? ❑ Yes X No Basement Fixtures? ❑ Yes No
Type of Wastewater System" (Initial) Wastewater Flow: 3LO GPD
(See note below, if applicable ;'~C-;710 (Repair)
Installation Requirements/Conditions Number of trenches
Septic Tank Size 1 00 gallons Exact length of each trench \90 feet Trench Spacin
g -L_- Feet on Center
Pump Tank Size gallons Trenches shall be installed on contour at a Soil Cover: 6 inches
Maximum Trench Depth of. inches -----(Maximum soil cover shall not exceed
(Trench bottoms shall be level to +/-I/4" 36" above the trench bottom)
in all directions)
Pump Requirements: ft. TDH vs. GPM inches below pipe
G gE ~r'¢o,Y, 5 SSA Aggregate Depth: inches above pipe
Conditions: A~Cri ~-tN - C -X
inches total
*If applicable: / Ynderrtand the system type specified it different from the type rpeci~ed on the app/icatian. /accept the rpec16catianr of this permit.
Owner/legal Representative Signature: Date:
This Construction Authorization is subject to revocatio q the site lilan, 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 su f mpliance Att wwions the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit. SEE ATTACHED SITE SKETCH
L'Lg
Authorized State Agent: Date: A
Construction Authorization Expiration Date: a
HTE# 10-5 . a31 L1 Permit # a5B°~ 6
Harnett County Department of 1- ~iblic Health
Site Sketvh
PROPERTY LOCATON: )l1 ` -i a~
ISSUED T0: SUBDIVISION LOT # \ 0
Authorized State Agent czC`~, ~~wCa'to~l~StbC Date: 10
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