IPAC RRHTE# 4/-=a�Z7r'XR Harnett County Department of Public Health 8 7
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
�' / n PROPERTY LOCATION: J�� .fid
ISSUED TO: 1 5• c�� ]'e✓ r e4 ! ` GN` SUBDIVISION LOT #
NEW 2"- REPAIR ❑ EXPANSION ❑
Type of Structure: J -FD
Proposed Wastewater System Type:
Projected Daily Flow: J i9 6 GPD
Number of bedrooms: Number of Occupants: to max
Basement ❑Yes 240
Site Improvements required prior to Construction Authorization Issuance:
Pump Required: ❑Yes Cho ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community 2—Public ❑ Well Distance from well feet
Permit conditions:
Permit valid for:
E -'Five years
❑ No expiration
Authorized State Agent::,%�-. ��* .e� Date: �%l/s'/evtsr SEE ATTACHED SITE SKETCH
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 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, .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: PROPERTY LOCATION: '4' ,'ea
SUBDIVISION LOT #
Facility Type: L -T New ❑ Expansion ❑ Repair
Basement? ❑ Yes ❑ No Basement Fixtures? ❑ Yes ❑ No
Type of Wastewater System** o21�r® ,2eJ 0 -'IL (Initial) Wastewater Flow: GPD
(See note below, if applicable ❑)
021`"%v f,I�ew.. (Repair)
Installation Requirements/Conditions Number of trenches 3
Septic Tank Size 1000 gallons Exact length of each trench 100 feet Trench Spacing:_ Feet on Center
Pump Tank Size gallons Trenches shall be installed on contour at a Soil Cover: Cr. inches
Maximum Trench Depth of: /6 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 inches below pipe
(�/ t Aggregate Depth: inches above pipe
Conditions: 1 v 6. A -y' /-I- !L l a C cs. eco ,y,ti d,rts , , `.`•c c c" inches total
erp o ten! NL a ✓ h e etleeJ 94
WATER LINES (INCLUDING IRRIGATION) MUST BE 10FT. FROM ANY PART OF SEPTIC SYSTEM OR REPAIR AREA.
NO UTILITIES ALLOWED IN INITIAL OR REPAIR DRAIN FIELD AREA.
**If applicable: l 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 change in ownership of the site. This
rnnstrurtinn Authorization is subiect 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 Agent• Date:�s'
Construction Authorization Expiration Date: `( /1l— 2 0 1 0
NTE # /./ s = a (-; `7J -1-R
Permit # ;2- 8A -?7
Harnett County Department of Public Health
Site Sketch
PROPERTY LOCATON: 14v A"$( ✓ems•
ISSUED TO: �! ay��o� v urw-w-: SUBDIVISION LOT #
Authorized State Agent: e _ Date: 44Zec—eli—
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