IPAC RHTE#~~-s ao~aa~ Harnett County Department of Public Health 2 5 8 9 4
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: L rtE~~ vt~, c ~uacti
ISSUED T0: SUBDIVISION J ~t mss,.,, C7~~5 LOT #
NEW f REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: 5C--'D (.,60'x)
Proposed Wastewater System Type: u ",e S o Co~v~ca~ Hv L
Projected Daily Flow: 3CE„O GPD
Number of bedrooms: 3 Number of Occupants: max
Basement ❑Yes `RCNo
Pump Required:`M~es ❑ No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community 'X Public ❑ Well Distance from well lb b feet Permit valid for: 'Five years
Permit conditions: ❑ No expiration
Authorized State Agent::
The issuance of this permit by the Health Department in no way guarantees t, ante
site is subject to revocation if the site plan, plat, or the intended use changes. The Im
the Laws and Rules for Sewage Treatment and Disposal and to conditions of this permit..
Date: la SEE ATTACHED SITE SKETCH
of other permits. The permit holder is responsible for checking with appropriate governing bodies in meeting their requirements. This
yement Permit 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, .1952, .1954, .1955, .1956, .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: PROPERTY LOCATION:
-s=~~v
( SUBDIVISION LOT #
Facility Type: SC~I~o'oC1~ New ❑ Expansion ❑ Repair
Basement? ❑ Yes "~K No Basement Fixtures? ❑ Yes1 No
Type of Wastewater System** (Initial) Wastewater Flow:_ GPD
(See note below, if applicable
Pu t•-+e o CoT+v~+oNP.t- (Repair)
Installation Requirements/Conditions Number of trenches i
Septic Tank Size s d o o
gallons
Exact length of each trench a0 C) feet
Trench Spacing: Feet on Center
Pump Tank Size no
gallons
Trenches shall be installed on contour at a
Soil Cover: inches
Maximum Trench Depth of. 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::
E
5 s
o.o rti Ss75 t c. S ys ~C K~
Aggregate Depth: inches above pipe
inches total
**If applicable: /understand the system type specified is different ftom the type specified an the application. / accept the specidcatians of this permit
Owner/Legal Representative Signature: Date:
Thic Cmtroc inn Anrhrin7itinn i, Aiarf-rn x .6
< - -1 I'll r_., r-1 numuncnuun Mini not oe transierrea when there is a change in ownership of the site. This
Construction Authorization is subject to compliance ' rovisloacf the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
C
Authorized State Agent: Date: ~ to
Constr ction Authorization Expiration Date: d/G S
HTE# C~ °S-2~°1~ _ Permit # aS 94
Harnett Counter Department of 1- ~iblic Health
Site Sketch
PROPERTY LOCATON: C-covll-~ Cap ~D
ISSUED TO: " scz Z 0 ~lj SUBDIVISION QKvs LOT #
Authorized State Agent: ~as~p~w~ 'TOC~svd,~ Date:
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