IPACHIE#_~!~' S Ica--~~yi~ Harnett County Department of Public Health 2 4 6 6 6
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
--7~ PROPERTY LOCATION: 7 -
ISSUED T0: / A Cep (,,J h ( SUBDIVISION _Q . rI . LOT
NEW REPA EXPANSION ❑ Site Improvements required prior to Construction Authonzanon Issuance:
Type of Structure: JN1 lP 2) B (L
Proposed Wastewater System Type: Avc
Projected Daily Flow: GPD
Number of bedrooms: Number of Occupants: _ max
Basement ❑Yes 14 No
Pump Required: ❑Yes A No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community Publ' 01~lell Distance from well Q feet
Permit valid for. Five ears
Permit conditions: 6t1± On C, ~ wA M,4 r✓'fAI IV 0 Y, f 2N ~C y
1 J ❑ No expiration
Authorized State Agent:: Lealth 1....1 Date: M SEE ATTACHED SITE SWICH
The issuance of this pernat by 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 Permit shall not be affected by a change in ownership of the site. This
permit is subject to compliance with the promions 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, .1955, .19K AM, .1958. and .1959 are incorporated by references into this permit and shall be met Systems shall be
installed in accords a with the attached system Is out.
ISSUED TO: 'fa C Li 1,. PROPERTY LOCATION:
SUBDIVISION IA ,-7 t 1t _ r LOT # Z
-
Facility Type: On H obi, k J L 3 (3R... >0 New El Expansion ❑ Repair
Basement? ❑ Yes -,JK1 No Basement fixtures? ❑ Yes -Z No
Type of Wastewater System*" _,Ga.A-J (Initial) Wastewater flow: _ GPD
(See note below, if applicable
lpgd on RecuiremmWCondWons L-P 0 (Repair)
Septic Tank Size _ gallons Exact length of each trench X oo feet
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of. I inches
(Tren(h bottoms shall be level to +1_114"
in all directions)
Pump Requirements: ft. TDH vs. GPM
Conditions:
C
Trench Sparing: f Feet on Center
Soil Cover. inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
inches below pipe
Aggregate Depth: inches above pipe
inches total
"If applicable l undeatand the JyJtem type rperiled it different from the type specified on the application. l accept the Jpecibrativnr of thin pemrit.
Owner/Legal Representative Signature: Date:
This Construction Authoriution is subject to revocation t the site plsn, plat, or the intended use changes. The Construction Authoritatan shall not be tnnslened when there is a change in ownership
of the site. This Construction Authorization is subject to compliance with the provisions of the taws and Auks (or Sewage Treatment and Disposal and to the conditions of this permit
SEE ATTACHED SITE SIrFTCH
Authorized State Agent Date: t~ ~ ~ 3
Construction Authonzation Expiration Date: t 3' I
HTE# t~ 5- I ~yI v Permit # Q?Y 4 ( to
Harnett County I),ppa,rtijell t ()f hiblic Health
Site Sketch
PROPERTY LOUITON.
I'D 7-
ISSUED TO: SUBDIVISION t LOT #
Authorized State Agent Date: b 3-17
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