IPACHTE# 8 x"00- 19Harnett County Department of Public Health 24661
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
I/ PROPERTY LOCATION: L S
ISSUED T0: ~Lrlf1 C....Mr• SUBDIVISION _ t?0c(j /L 4-
LOT
pe of LOT # L
REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization issuance:
T of Stratton: lL
Proposed Wastewater System Type: 'L s^
Projected Daily flow: 3 GPD
Number of bedrooms: 3 Number of Occupants: (p max
Basement ❑Yes No
Pump Required: ❑Yes ❑ No X May be required based on final location and elevations of fatalities
Type of Water Supply- ❑ Community Public ❑ Well Distance from well S J feet Permit valid for 0 Five years
Perm At conditions: S~~ f5 0 Q}, ~r,~~~~ f~al\o~~ A S./t"ca.~t..c( ~e it ~r h 4~~ El No expiration
Authorized State Agent: Date: 7) 7-- lib I I - O y SEE ATTAINED SITE SM01
The issuance of this permit by a 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 ' subject to revocation if 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 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..1952, .I9S4, .1955, .1956, .1957. .1959, 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: ~Ccnn-r- -t-L. PROPERTY LOCATION: a2 J
rn SUBDIVISION ~C -4 LOT #
facility Type: 5'V U S21.,39. '3R(L New ❑ Expansion ❑ Repair
Basement? ❑ Yes -4~1 No ~ ~Basement ixt res? ❑ Yes -0 No /
Type of Wastewater System" _l J. (Initial) Wastewater Flow: 3(p. GPD
(See note below, if applicable 1
-(Repair)
IRSW40 Aeq&in OWConditiot~
Septic Tank Size _.I D9_ gallons
Pump Tank Size gallons
Pump Requirements: ft. TDH vs.
Conditions:
Exact length of each trench X c 1 feet
Trenches shall be installed on contour at a
Maximum Trench Depth of ((9-Qy-- inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
GPM
Trench Spacing: _ c1 Feet on Center
Soil Cover. C, inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
inches below pipe
Aggregate Depth: inches above pipe
inches total
**If applicable: / understand the system type specified is different from the type speciped on the application. / accept the .rpeciftmions of this permit.
Owner/Legal Representative Signature: Date:
This Construction Authorization is subject to revocation if the site plan, plat or the intended use changes. The Construction Authorization shall not 6e transkrred when there is a change in ownership
of the site. This Construction Authorizati ubject to compliance with the provisions of the Vws and Rules for Sewage Treatment and Disposal and to the conditions of this permit.
t~ ) SEE ATTACHED SITE SKETCH
Authorized State Agent: Date: d 3 - ' i C) ~6
Construction Authorization Expiration Date:
HTE# 0 9. 5D3 - ~ I Of ~ Permit # 0? ~ (0 (0
Harnett Comity Depailineut of Public Health
Site Sketch
PROPERTY LOCATON: 1)
ISSUED T0: _ cl,~W c M~ SUBDIVISION [~cl h• ►1~ LOT # L
Authorized State Agent Date:
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