IPACHTE# j3 / '7 C Hati,ett County Department of Public rlealth
Imarovement Permit 27500
A buildi g permit cannot be issued with only an Improvement Permit
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/ ,, PROPERTY LOCATION: /8S'o
ISSUED TO: r �ror (e ,se SUBDIVISION _v,i,, -1-4f 4 x LOT # 1.5'
NEW 2' REPAIR ❑ EXP SION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: E4; t-: '4 'SFn
Proposed Wastewater System Type: c_ a _Q
Projected Daily Flow: J 6 O GPD
Number of bedrooms: 3 Number of Occupants: max
Basement ❑Yes 9116
Pump Required: ❑Yes 9' o ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community public ❑ Well Distance from well feet Permit valid for: CKFive years
Permit conditions: ❑ No expiration
Authorized State Agent:: v --- . /—cc ' IJ Date: I / i/ Z ° t l SEE ATTACHED SITE SKETCH
The issuance of this permit by t 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 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 systemm/ layout. rr
ISSUED T0: /� r- t �-�h ; �t<cU %�� i �fc PROPERTY LOCATION: / f�f G % : c Ra'•
SUBDIVISION J Ife_ f R,dg,,_ LOT # /Jr_
Facility Type: 2"'New ❑ Expansion ❑ Repair
Basement? ❑ Yes 2"'No Basement Fixtures? ❑ Yes ❑ No
Type of Wastewater System ** C c.1 ✓e"-F: ----Q (Initial) Wastewater Flow: .3 ° GPD
(See note below, if applicable ❑) n
Pt C�.We,e �->o�JC (Repair)
Installation Requirements /Conditions Number of trenches
Septic Tank Size gallons Exact length of each trench % feet Trench Spacing: `� Feet on Center
Pump Tank Size gallons Trenches shall be installed on contour at a Soil Cover: a2 inches
Maximum Trench Depth of: 3 �- inches (Maximum soil cover shall not exceed
(Trench bottoms shall be level to +/ -1/4" 36" above the trench bottom)
in all directions)
Pump Requirements: ft. TDH vs. GPM
Conditions:
�u � 1, -
ls� 1.'e M -.T1 9c cQ.pp'4 , �k' b °60X.
on TeP c 4-a -w.k- S a .,SL he La,tcc ✓ed -,k- V _ ,.4;,r.,( -<-
6 inches below pipe
Aggregate Depth: .2 inches above pipe
/2, inches total
WATER LINES (INCLUDING IRRIGATION) MUST BE LOFT. FROM ANY PART OF SEPTIC SYSTEM OR REPAIR AREA.
NO UTILITIES ALLOWED IN INITIAL OR REPAIR DRAIN FIELD AREA.
* *If applicable: I understand the system type specifled is different from the type speciTed on the application. / accept the specifIcatiom 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 be transferred when there is a change in ownership of the site. This
Construction Authorization is subject to compliance with the provisions of the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this
Authorized State Agent Date:
Construction Authorization Expiration Date:
SEE ATTACHED SITE SKETCH
HTE#
H(arnett County
Permit # dl"?S—bc�
Depart lite] it of Public Health
Site shetch
Mha'MP4
PROPERTY LOCATON: /8,5-0 % All
ISSUED TO: A- Tk" *
lj ire SUBDIVISION LOT # IJ-
Authorized State Agent: Date:
I Li
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