IPAC RHTE# CA Harnett County Department of Public Health 2 5 91 8
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: G+z EEXSy~tt[ Ciayctt CL~
ISSUED TO: ciosZ ~SZ i tL~ SUBDIVISION J p~)z Q a CS LOT # 19~
NEW REPAIR ❑ --EXPANSION [I Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: 5 V U ~ x ~~6
Proposed Wastewater System Type:
Projected Daily Flow: yY O GPD
Number of bedrooms: L--)t Number of Occupants: max
Basement ❑Yes No
Pump Required: ❑Yes ❑ No A May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community 1~1 Public ❑ Well Distance from well 'i-C)O feet Permit valid for: Five years
Permit conditions: ❑ No expiration
Authorized State Agent:: V _ Ct G-~l
The issuance of this permit by the Health Department in no way guarantees once
site is subject to revocation if the site plan, plat, or the intended use changes. The 160
the Laws and Rules for Sewage Treatment and Disposal and to conditions of this permit.
Date: 31 C, ~ ) b SEE ATTACHED SITE SKETCH
of other permits. The permit hold is responsible for checking with appropriate governing bodies in meeting their requirements. This
~Tent 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, .1957, .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: -:~s 'S yQ< ( ~11
Facility Type: SC-"L7 (6`l x6qf-) New
Basement? ❑ Yes t~,) No Basement Fixtures? ❑ Yes
Type of Wastewater System**
(See note below, if applicable
Installation Requirements/Conditions
Septic Tank Size I QbO gallons
Pump Tank Size gallons
Pump Requirements: ft. TDH vs.
PROPERTY LOCATION: C.a-CLyFSv ILZ-C
SUBDIVISION Z L-, -i,) O o 5 LOT # 7~
❑ Expansion ❑ Repair
No
Sw5`rcM (Initial) Wastewater Flow: GPD
Number of trenches l
Exact length of each trench gOd feet
Trenches shall be installed on contour at a
Maximum Trench Depth of: Sa= X inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
GPM
Trench Spacing: Feet on Center
Soil Cover: <o inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
inches below pipe
Aggre ate Depth: inches above pipe
Conditions: ~v~ NGE~Et~ ov(~L nQC ~ GL~, MG C Q N ate Depth:
inches total
C~',NAL 1--~~0U 7 f3E 1b~ S=rztlrr S~~G S~,s~~M
**If applicable: / understand the system type specified is different From the type specified on the app/iwion. /accept the sped 1icatianr of this permit.
Owner/legal Representative Signature: Date:
Thi, (-t-ti- durhnri-m.
- - r.u,,, r.w 11-%". nic ~mWFUUIUn numonzorion snau not oe transferred when there is a change in ownership of the site. This
Construction Authorization is sub ect to compliance wi h The prQnsio" the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent: ~ Date: 3 CAJI 0
Constr 'on Authorization Expiration Date: 3 ~S
HTE# Permit # 2S'~\%
Harnett ('aunty Depailment of h-tblic Health
Site ketch
PROPERTY LOCATON: CSC-EY-SV ~LLZ C,,, 2 l'~
ISSUED TO: ~ S p p t SUBDIVISION S " 1..\ ~ Gam LOT # 1$
Authorized State Agent: 99-4a,56L`v(11 1 oL-C~c Date: )d
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