IPAC RHTE# 0 e- 5-: 11 Harnett County Department of Public Health 2 5 9 8 2
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
ISSUED T0: _ ✓~t CcA~ PROPERTY LOCATION: u y
NEW f~ REPAIR El ,,n SUBDIVISION ~ R a
EXPANSION 171 LOT #
Type of Structure: (.l J- ~f-+ Site Improvements required prier to Construction Authorisation Issuance:
Proposed Wastewater SysteType:(~ ~2 5~%~ c v L F -t om
Projected Daily Flow:, GPD -
Number of bedrooms: 3 Number of Occupants: (I max
Basement ❑Yes N
Pump Required: ❑Yes ❑ No 211i e brequired based on final location and elevations of facilities
Type of Water Supply: ❑ Community Q/Public ❑ Well Distance from well
Permit conditions: feet Permit valid for. 4? Five years
❑ No expiration
Authorized State Agent:
The issuance of this permit by the Health Department in no way guarantees the issuance of other permits. The permit holder is responsible for checking with
appropriate governing SEbodies in meeting their E ATTACHED SITE SKEiTements. 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, .1951, .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:S/ri ,~-C~IFvc~° ova PROPERTY LOCATION: w•
SUBDIVISION 77~ LOT #
Facility Type: Is- FID 2 New ❑ Expansion ❑ Repair
Basement? ❑ Yes ❑ No Basement Fixtures? Yes ❑ No
Type of Wastewater S stem"
y - --r ",~Z 3e-1 " ' `r~ `O`er (Initial) Wastewater flow: (i
(See note below, if applicable GPD
y~"~P ~u a2S-~u ~e~vc~~cc1.SyI~-(Repair)
Installation Requirements/Conditions Number of trenches
Septic Tank Size 00 0 gallons Exact length of each trench S Q
Pump Tank Size gallons - feet Trench Spacing: 9 Feet on Center
g Trenches shall be installed on contour at a Soil Cover: _ C 2_ inches
Maximum Trench Depth of: 18 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: It. TDH vs. GPM
I*1nef ei (.V, A_ ttG jI '
yr`cpr,`.c-
**If applicable: /
A regate Depth:
~r Alt, a
r c KM T ~~E L 'lli A J'v I , Lt 'rc X the cyrtem type speci>ied is dillerent from the type rpeci6ed oo the app/ication. / accept the roecificationr of this permit
Owner/Legal Representative Signature:
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 com nce 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 Agen / .1 fi "
Date: 51-11
Construction Authorization Expiration Date:
~ fem. G
inches below pipe
inches above pipe
inches total
HTE# 0 L(3,NX
Permit # o2 -9
Harnett County Department of l' -tblic Health
Site Sketch
ISSUED TO: ~y u PROPERTY LOCATON: w ,2 ?
A Cc& J` SUBDIVISION
LOT #
Authorized State Agent. `
Date: ~5- .2 2 ~2~t a
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