IPACHTE#-oz's-"~53 Harnett County Department of Public Health 2 4 5 4 6
Improvement Permit
A building permit cannot be issued with only an improvement permit
PROPERTY LOCATION:_ `Ti a , RQ g~~ ~p
ISSUED TO: P >,-c Ea S w Ar+l~t _ SUBDIVISION NEW >1, REPAIR ❑ E~PANSION ❑ - - LOT #
Type of Structure: P,tr. 1~o~E 2 Site Improvements required prior to Construction Authorization Issuance:
Proposed Wastewater System Type: x5 K-1 E N : N P L,
Projected Daily flow: 3~0 GPD T
Number of bedrooms: 3 _ Number of Occupants: m
Basement ❑Yes No
Pump Required: ❑Yes n No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community "N Public ❑ Well Distance from well ti
Permit conditions: feet Permit slid for.
five years
❑ No expiration
Authorized State Agent.: 95 _
~ SEE ATTACHED SITE SNETCH
The issuance of this permit by the health Department in no way guarant a issuance of other Date:3 l permits. he 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 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,
installed in accordance with the attached system layout. .1952, .1954, .1955. .1956, .1952, .1958, and .1959 are incorporated by references into this permit and shall be met. Systems shall be
ISSUED T0: _ rr 1Pa_~~z 5 , t~N N
PROPERTY LOCATION: T, cQ , ~,g~,~~} ~t
Facility Type: ~o c~ (pia x~~ SUBDIVISION
LOT #
Basement? ❑ Yes ~ No Basement fixtures? ❑ YeseW ~No Expansion ❑ Repair
Type of Wastewater System*` Ca .e v N A L
(See note below, if applicable -(Initial) Wastewater Flow: 3L GPD
1440W Ite440'.'A &Cv 5sc.i~,N C-ONIJs~,nr,\O'Jp'.~
inntteftW (Repair)
_ ondi6M
L4 7Q'S.NGltCS
Septic Tank Size t_ ao _ gallons Exact length of each trench lo (z) feet
Pump Tank Size gallons Trenches shall be installed on contour
Maximum Trench Depth of: _ }2 ' aL( inches
(Trench bottoms shall be level to +/-I/4"
directions)
Pump Requirements: TDN vs. in all GPM
Conditions:
**If applicable
Owner/Legal Representative Signature:
This Construction Authorization is subject
of the site. This Construction Authorizadan,is
Authorized State Agent:
Trench Spacing, feet on Center
Soil Cover, _(-:S inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
inches below pipe
Aggregate Depth: 2 inches above pipe
) inches total
l underJtand the i}stem
type r p ecrfied it different from the type .rpeciled on the application. / accept the rpecilinwom of thin permit.
_ 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
iance 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) Z~ 0~3
struction Authorization Expiration Date: -3 ) 1 113
HTE# C~ -S- l9 53 4
Permit # a4 5 Lv L
Hamlett County Ieparti,jell t of hiblic Heald,
Site Sketch
PROPERTY LO(ATON: i a, ) ISSUED TO: SUBDIVISION
LOT #
Authorized State Agent: Q.5 (o L, vE 701.y
D o
Date: -3
Ili
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