IPAC RHTE#
Harnett Co
~a-s- unty Department of Public Health 2 5 8 6 9
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
ISSUED T0: PROPERTY LOCATION: PoHO~~~~A ~2P+s a
~s l~G SUBDIVISION Cc" L) p S
NEW' REPAIR ❑ PANSION 11 ~.P,sotv5 LOT #
Type of Structure: 5 O t 1(, "xyy Site Improvements required prior to Construction Authorization Issuance:
Proposed Wastewater System Type: Pur.,P7
o NJEt.t : so1rAL- -S~~ CiOr.lrJt-` \ OcJ
Projected Daily Flow: 36 -C GPD
Number of bedrooms: 3 Number of Occupants: max
Basement ❑Yes X No
Pump Required: ❑Yes ❑ No X May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community ,Public ❑ Well Distance from well _ COD
Permit conditions: feet Permit valid for. Five years
❑ No expiration
Authorized State Agent.:
Date: 1 3-~ 10 SEE ATTACHED SITE SKETCH
The issuance o/ this permit by the Health Department in no way guarantees the issuance o er 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 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 .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 T0: ~rJP~`SC~ cmci,~ 1~totS r G PROPERTY LOCATION: ~o rti
~ac,Sc. 1a~,y
Facility Type: 5< LA L~ SUBDIVISION Gela.oc,a~,P SoN LOT # ~8 y
~ New ❑ Expansion ❑ Repair
Basement? ❑ Yes No Basement Fixtures? ❑ Yes >,No
Type of Wastewater System- Q uMe -rcb (:~v N yet , s d
(See note below, if applicable L (Initial) Wastewater Flow: U, (~l GPD
P v t~,P Q 00u'4 E'r3 I'll N 0.L-, (Repair)
Installation Requirements/Conditions Number of trenches a,
Septic Tank Size Lc) in O gallons Exact length of each trench 7 S
Pump Tank Size ~ o (Z p gallons feet Trench Spacing: ~ Feet on Center
g Trenches shall be installed on contour at a Soil Cover: i~ inches
Maximum Trench Depth of. inches (Maximum soil cover shall not exceed
(Trench bottoms shall be level to +1-114" 36" above the trench bottom)
in all directions)
Pump Requirements: ft. TDH vs. GPM
_ inches below pipe
Conditions: Wes,: Lan,L MoS~ ~t ' F- Aggregate Depth: ~ inches above pipe
.AV Q~ ~ G 5;-- - C-",- ,N SIC- inch;-- es total
C'~Q, rrC A~NEp Q V rnP ~A•f UG
**If applicable: / understand the system type specified is different from the type specified on the application. / accept the specifications of this permit
Owner/Legal Representative Signature:
This Construaion Authorization is subject to Date:
f the site plan, lat, or the intended use changes. The Construction Authorization shall not be transferred when there is a change in ownership of the site. This
Construction Authonzation is so compliance with the and Rules for Sewage Treatment and Disposal and to the conditions of this permit,
SEE ATTACHED SITE SKETCH
Authorized State Agent:
Date: t
on Expiration Date:
HTE# 0lp~
Permit #
Harnett ('oun ty I)epailment of -hiblic Health
Site Sketch
PROPERTY LOCATON: Pa 14 0L- 2 ,s P\ 7g-;~
ISSUED TO: c,-s ~cxt~L 0r,ES tiC, SUBDIVISION
~-O~aN ~ SapSo,aS LOT # '%L-"
Authorized State Agent: }~s (CzL , Vert, o
Date: la
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