IPAC RHTE# 0t 500--19763 Harnett County Department of Public Health 2 5 5 2 3
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION- C a
ISSUED TO: J 5~A_ kcC Ia SUBDIVISION &I Sr (3✓ ta2 c t ✓a LOT #
NEW REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:O Y, 82 r4
Type of Structure: i,J (VIN
'4 R(Z
Proposed Wastewater System Type:
Projected Daily Flow: GPD
Number of bedrooms: Number of Occupants: (V max
Basement ❑Yes 'J~Qlo
Pump Required: ' ks ❑ No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community P Iic ❑ Well Distance from well I ~Q ~ , feet Permit valid for. 5W Five years
Permit conditions: Mect cAc -tic rry,p,-( 14*o-4- Mai 11~&r W A~ ~ RN k -.v ❑ No expiration
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Authorized State Agent:: _ fvc(CF /'(T Date: ..5- 3313--t J SEE ATTACHED SITE SKETCH
The issuance of this permit by the Hea 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 sit 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: Lff cP,.r- ~Pr,Le,Ya- PROPERTY LOC TION: ()C 9'1
SUBDIVISION EdY A, 0t, c,,,,,, LOT #
Facility Type: [)w ,M 14 "RU x `f y - 3~ -X New ❑ Expansion ❑ Repair 02V g Z
Basement? ❑ Yes -J4- No Basement Fixtures? ❑ Yes No
Type of Wastewater System** (3 (L Av~ (Initial) Wastewater Flow: GPD
(See note below, if applicable /J
LtA" _6 9)_% 6M-lb" S (Repair)
Installation Requirements/Conditions Number of trenches "
Septic Tank Size _1003 gallons Exact length of each trench ___aDo feet
Pump Tank Size 13 3 gallons Trenches shall be installed on contour at a
Maximum Trench Depth of- 4'' 1) inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
Pump Requirements: ft. TDH vs. GPM
Conditions:
Trench Spacing: -Ci_ Feet on Center
Soil Cover _6~,_ inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
Aggregate Depth:
_1~_ inches below pipe
Z inches above pipe
_12~-_ inches total
**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: 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 chance in ownership of the site. This
tonstructmn Authorization is subject to co ce with 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: S J
Construction Authorization Expiration Date: 1-off -3 to r
HTE# Di"~0-- Lq 7 63 R- Permit # 05 K 01.3
Harnett County Department of 1- i blic Health
Site Sketch.
~~11 PROPERTY LOCATON: C o11
ISSUED TO: `~4/~c na SUBDIVISION LOT #
Authorized Slate Agent: (I W -A- 9-,e kt ) Date: S -I a--- k a L
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Department of EmA ronnmt, Health and Natural Resources
Division of Environmental Health Shed:
show 1D: Property On-Site Wastewater Section Lot #
SOR.JSITE &YALUATION File M:
for ON-SITIE WAST>tWATEIt SYSTEM Code:
09I~g1.3t
Owner. Applicant:
Addrew. Data Evaluated:
Proposed Facility: DeAP Flow (.1949): Property Size:
Location of SitlK Property Recorded:
Water Suppig Publk ❑ Individual ❑ Well ❑ Spring ❑ Other
Evaluation Method: ~:~Xuger Boring ❑ pit ~
Type of Wastewater: j❑ Sewage ❑ Industrial process Mixed
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1 .1940 .1941 PROFIL$ FACTORS
L Ludoap Horizos 19k~
A 0 Posidad 17ep11r .1941 .1941 .son 144s 1916
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