IPACHTE# CF-J-- /7$J`--3 Harnett County Department of Public Health 2 4 5 6 5
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
t PROPERTY LOCATION: / / 5/Sr /
ISSUED T ~4fe t~ f. ~j . C r~n er SUBDIVISION ~Q S(ftr e LOT # g
NEW REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: _~SF A. Y_
ry,
Proposed Wastewater System Type: v cc, "d r~s..
Projected Daily Flow: 6 GPD
Number of bedrooms: - -7 Number of Occupants: _.G max
Basement ❑Yes / L`S No
Pump Required: [9Yes ❑ No ❑ Mae required based on final location and elevations of facilities
Type of Water Supply: ❑ Community I T Public ❑ Well Distance from well feet Permit valid for. Five years
Permit conditions: ❑ No expiration
Authorized State Agent.: Date: -7 /17 / `c of
SEE ATTACHED SITE SKETCH
The issuance of this permit 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 is subject to revocation if the site plan, plat, or the intended use changes. The Improvement Perrrut 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, .1954, .195S, .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: .T-asc~rlL /a'I • G "1-4, PROPERTY LOCATION: S~ ryc/~
SUBDIVISION _1b,1(-- c LOT #
Facility Type: .SFQ 5 cr Xs y New ❑ Expansion ❑ Repair
Basement? ❑ Yes 6'No Basement ixtures? ❑ ,YEt ❑ No
Type of Wastewater System"' e ccC'Icc~ „(Initial) Wastewater flow. -7C G GPD
(See note below, if applicable
PU • `roTtct ct,~~ ~f .T f~+c (Repair)
Installlation Bequirtxtunts/Ctmditions
Septic Tank Size 1W6 gallons
Pump Tank Size t70 gallons
Pump Requirements: ft. TDH vs.
Exact length of each trench ')49'Q feet
Trenches shall be installed on contour at a
Maximum Trench Depth of: Id - G inches
(Trench bottoms shall be level to +/.I/4"
in all directions)
GPM
Trench Spacing. ? Feet on Center
Soil Cover. sZ`/ inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
inches below pipe
Aggregate Depth: inches above pipe
Conditions:1) r,:,-.1 I .tiv 6c V.
1% r- 1.SA Aced -k, bL r inches total v
J o C."\ -CG e.,r-` r . SC e...c ~ e..- ' t:. ta41 l.. a ~,.s,ti l d ✓ b
-If applicable: / under od the system type specified a different from the type rpecified on the app/ication. / accept the rpec1f1cat1o#f of this permit.
Owner/Legal Representative Signature: _ Date:
This Construction Authonntion is subject to revocation if the site plan, 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 Authoriza~towsubject to compliance w' the provisions of the laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit.
( SEE ATTACHED SITE SKETCH
Authorized State Agent: Date: 4,Z712 Construction Authorization Expiration Dat` t 1
HTE# 0'? s =1FS'-5-? Permit # -~Z q S6S
Harnett County I ep'-full gent of ll~jblic Health
Site Sketch
PROPERTY LOCATON:
ISSUED T0: osz p~ /1I. Ga d~v- SUBDIYI9ON
LOT #
Authorized State Agen Date: /21"F
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