IPAC RHTE# I1:->-- 5 f�, Harnett County Department of Public Health 28341
15 -S 3� �� A6� Improvement Permit
A building permit cannot be issued with only an Improvement Perm
PROPERTY LOCATION: �t ISSUED T0: 'J ®t.}ra my AN SUBDIVISION f t_ �-. PaC. C LOT #
NEW N' REPAIR ❑ _ EXPSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: SVC) Q -1S 'Y �-}
Proposed Wastewater System Type: a.�"� c, U Gi t c v4 ys e4,c\
Projected Daily Flow: 350 GPD
Number of bedrooms: 3 Number of Occupants: max
Basement E--]YesNo
Pump Required: ❑Yes No ❑ 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: Five years
Permit conditions: ---. �— ❑ No expiration
Authorized State Agent:: Date: SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the issu other permits. The permit holder is respo Bible 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: =GI—) t4 n � PROPERTY LOCATION: t t a:Lw—e cZ
SUBDIVISION 1 Z(.2A-,A Vi -)—, LOT # 4
Facility Type: 5'fQ `-7' " 62�) New ❑ Expansion ❑ Repair
Basement? ❑ Yes �k No Basement Fixtures? ❑ Yes XNo
Type of Wastewater System** �s`o GA�)V 21 1 P tJ S �'S 1 6—t>� (Initial) Wastewater Flow: 3� Q GPD
(See note below, if applicable ❑) ® nn
c /0 1`�- �_ ` lz �' 1 a (Repair)
Installation Requirements/Conditions Nssmhpr of trPnchpt 3
Septic Tank Size 1 p C) ?3 gallons
Pump Tank Size gallons
Pump Requirements: ft. TDH vs.
Conditions:
Exact length of each trench i®
Trenches shall be installed on contour at a
Maximum Trench Depth of: it -3C
(Trench bottoms shall be level to +/-1/4"
in all directions)
GPM
feet Trench Spacin : Feet on Center
Soil Cover: inches
inches (Maximum soil cover shall not exceed
36" above the trench bottom)
Aggregate Depth:
WATER LINES (IN(LUDING IRRIGATION) MUST BE ]OFT. FROM ANY PART OF SEPTIC SYSTEM OR REPAIR AREA.
NO UTILITIES ALLOWED IN INITIAL OR REPAIR DRAIN FIELD AREA.
inches below pipe
inches above pipe
inches total
**If applicable: / understand the system type specified is different from the type specified on the app/ication. /accept the specifications of this permit.
Owner/Legal Representative Signature: Date:
This Construction Authorization is subject to rev if thejite 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 iscomplian ' h the p f the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit. SEE ATTACHED SITE SKETCH
Authorized State Agent: Date: C
Con ction Authorization Expiration Date: _
HTE# `5- 5-
ISSUED TO:
Authorized State Agent:
N
Permit # �`� q
Site Slietch
PROPERTY LOCATON: —1-1 a, -2 -'PM Ort..
SUBDIVISION - Q;Zk-%-) Nj 1 i.:). C LOT # _
j 61 Y�tJt7�)Date: (4 n I)-�,
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