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IPAC RType of Structure: /t ' S,FD Proposed Wastewater System Type: F S X > _ Projected Daily Flow: tlJ?D PD Number of bedrooms: !— Number of Occupants: max Basement ❑Yes ❑ No Pump Required: ❑Yes ❑ No LS Mbe requiredVssed on final location and elevations of facilities Type of Water Supply: El Community LLYII Public LJ Well Distance from well 5'� feet Permit conditions: /J9,) %; ,OK 7-0 ! x x-5 ~ y „< 'J 4 i 7— 7-Z o / Permit valid for: /Five years �] No expiration Authorized State Age :: /mac Date: _Zc% v9 SEE ATTACHED SITE SKETCH The issuance of this permit by a alth Department in no way guarantees the issuance of other permits. The permit holder is responsible for checking with appropriate kerning bodies in meeting their requirements. This site is subject to revocation if 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, .1956. and .1959 are incorporated by references into this permit and shall be met. Systems shall be installed in accordance with the attached system layout. r_. ISSUED TO: ZU 4- 4- ,Z /) - PROPERTY LOCATION: .S /z-/5Z s' l�r c�� DIVISION LOT # Facility Type: °!� El New Expansion ❑ Repair Basement? ❑ Yes No Basement Fixtures? ❑ Yes ❑ No Type of Wastewater System ** (Initial) Wastewater Flow: /80 GPD (See note below, if applicable ❑) t s` s (Repair) Installation Requirements /Conditions Number oOtrenches _ _jn! - Septic Tank Size 12 o ® gallons Exact length of each trench _ C� feet Pump Tank Size gallons Trenches shall be installed on contour at a Maximum Trench Depth of. 6t inches (Trench bottoms shall be level to +/ -1/4" in all directions) Pump Requirements: ft. TDH vs. GPM Conditions: AIL- LJ "�"'�r,1Y. 15 RM Trench Spacing: `? Feet on Center Soil Cover: I La inches (Maximum soil cover shall not exceed 36" above the trench bottom) iV inches below pipe Aggregate Depth: a2 inches above pipe / ;2- inches total * *If applicable: l ullderstand the system type specified is different from the type specified on the application. l 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 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 permit. SEE ATTACHED SITE SKETCH Authorized State AgentL Date: P- Z 41 - itf Construction Authorization Expiration Date: Z HTE# zt Z 8 Z R Permit # 25'11 7 Harnett County Department of -tblic Health Site Sketch PROPERTY LOCATON:J/Z i�57 © S ISSUED T0: `�Ur� /�C° SUBDIVISION LOT # Authorized State Agent. h Date:° °p o , 3 Q4-- ,X&) Aeall� ?lo' Zi(>'