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HTE# o~-s- IA LQ ) Harnett County Department of Public Health 2 4 5 4 2
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: waos M1t-c-.
ISSUED T0: ~ Lr1E-c ~ ~L S M ps"rTHt^~rv~__ SUBDIVISION Qz,, %.i S ut3o%v ssso N LOT # 10_
NEW'X REPAIR ❑ EX NSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: _5 !-C7 n> 3 ~
Proposed Wastewater System Type: C~-3 r-i ve~+;l t _
Projected Daily Flow: L- Ac) GPD
Number of bedrooms: y Number of Occupants: g max
Basement ❑Yes X No
Pump Required: ❑Yes 75 No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community Public Cl Well Distance from well __VC_ feet Permit valid for. lAive years
Permit conditions: ❑ No expiration
Authorized State Agent: Date: 31 51 Q$ SEE ATTACHED SItE SKETCH
The issuance of this permit by the Health Department in no war guarantees the iss of other permits. The perrtnt holder is responsive for checking with approprate governing bodice in meeting
their requirements. This site is subject to revocation if the site plm, 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, .1951, .1954, 1955, A956, A951, .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 TO: Ot✓~E-~R-~<- 5 N1vtt~~~wS PROPERTY LOCATION: 1`1205 ~st_L Rn
SUBDIVISION Cowk" s1Jsp~y\S\d,a LOT # _\Q_
Facility Type: 5Fp ~~3rXS 3f/ New ❑ Expansion ❑ Repair
Basement? ❑ Yes 4~k No Basement Fixtures? ❑ Yes >~,No
Type of Wastewater System" Ca N V &-'c t o a KL~ (Initial) Wastewater Flow- ~l $b GPD
(See note below, if applicable
~ Erv S sCS tv A L (Repair)
Inst,Ma N Aegeataneftts/Ctsndidatfs
Septic Tank Size ► OHO gallons
Pump Tank Size gallons
Pump Requirements: ft. TDH vs.
Conditions:
Exact length of each trench B0 feet
Trenches shall be installed on contour at a
Maximum Trench Depth of 3(o inches
(Tren(h bottoms shall be level to +/-1/4"
in all directions)
GPM
Trench Spacing. C1 Feet on Center
Soil Cover. _ a4 inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
inches below pipe
Aggregate Depth: a inches above pipe
i a, inches total
"If applicable: l understand the system type specified it different from the type specified on the application, l accept the Jpeoficationr of thin permit
Owner/Legal Representativ Si natur
This Construction Authorization is subject to
of the site. This Construction Authoriration'm
Authorized State Agent:
Date:
if the site plan, plat, or the intended use changes, The Construction Authorization shall not be transferred when there is a change in ownership
with the provisions of the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit.
SEE ATTACHED SITE SKETCH
Date: 3 s 0
Con ction Authorization Expiration Date: 3 S i
NTE# CA' S- S9 L)-1 i Permit #
Harilett County Department of I'llblic Health
Site Sketch
PROPERTY LOCATON: x-4-06 ~A I u ~-0
ISSUED TO SUBDIVISION ~w ..N S ~g 4~v ~s~o•,I LOT
Authorued State Agent Q=5 ~a~-~vtti "Solo Date: 3I 5~d~
t~1