IPAC RHTE# /5--S - 3 5 g ?D iz Harnett County Department of Public Health 28460
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
/ PROPERTY LOCATION: � t .5
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ISSUED TO. 04{% C�' 1� �%y9 J�1C='� . SUBDIVISION Zev? Z� ,g7,nr,;z,�c_ . LOT # !
NEW REPAIR 0 EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance: TTT—
Type of Structure:
Proposed Wastewater System Type: 0 s A r
Projected Daily Flow:g GPD
Number of bedrooms: Number of Occupants: max
Basement ❑Yes LI No ��
Pum Required: ❑Yes ❑ No L� Ma be required b ed on final location and elevations of facilities ��
TypeofWater Supply: ❑ Community Public q YWell Distance from well f P feet Permit valid for: a, Five years
Permit conditions: ❑ No expiration
Authorized State `( Date: 1— 2--7 S'` SEE ATTACHED SITE SKETCH
The issuance of this permi��rtment 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 revoatior 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: 4ff %
SUBDIVISION L �rcl-�' ,T �LOT # t
Facility Type: Z New �❑E Expansion El Repair
Basement? El Yes No Basement Fixtures? El Yes l.d No
Type of Wastewater System** Z,�� )�4b)1 J� 7 _ (Initial) Wastewater Flow: � GPD
(See note below, if applicable ❑) �
1%11 /Z�%ilC.�.G/J?.� � (�Repai�
Installation Requirements/Conditions Number of trenches 2, ..
Septic Tank Size 1066 gallons Exact length of each trench1W 0C 96feet
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of:inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
Pump Requirements: ft. TDH vs. GPM
Conditions:
Trench Spacing: < Feet on Center
Soil Cover: inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
Aggregate Depth:
WATER LINES (INCLUDING 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
%2- inches total
**If applicable: /understand the system type specired is different from the type specified on the application. / accept the speciTcations 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 ownershia 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 Stateent: Date:
Construction Authorization Expiration Date: "7--'7 -- 7.'ct�
HTE# 1S-- 1;-- 86 Z Permit # � (p
Harnett County Department ®f niblic Health
Site Sketch
PROPERTY LOCATON:� 1-7,99�.S'�-�,-12�i�-17� /66ISSUED T0: / Z`C:� ��� J,I��n1C�( SUBDIVISION —CSL'"".. �g LOT #
Authorized State A�"" Date: % —15-
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