IPACHTE# Y08 Harnett County Department of Public Health 28415
Improvement Permit
A building permit cannot be issued with only an Improvement Pegrmit
PROPERTY LOCATION: X,
ISSUED T0: SUBDIVISION y s'c� r f"la i d LOT #
NEW ❑ REPAIR CI E PANSION Pf Site Improvements required prior to Construction Authorization Issuance:
Type of Structure:
Proposed Wastewater System Type:�-e�—
Projected Daily Flow: Y8 6 GPD
Number of bedrooms: Number of Occupants: _max
Basement []Yes filo
Pump Required: ❑Yes CYT No ❑Ma be required based on final location and elevations of facilities
Type of Water Supply: El Community Public ❑ Well Distance from well feet Permit valid for: ZFive years
Permit conditions: ❑ No expiration
Authorized State Agent:: . - Date: 2--c - SEE ATTACHED SITE SKETCH
The issuance of this permit b the Health bepartmenL414 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 TO: �5� � Ca.0 C'Me PROPERTY LOCATION: �P_oc. 1111-1// c/`
,p SUBDIVISION b r,,d -, /'1, // LOT #
Facility Type: 6Si�J E] New C? Expansion ❑ Repair
Basement? ❑ Yes ❑ No Basement Fixtures? ❑ Yes ❑ No
Type of Wastewater System** s-7, grd aK f/lle (Initial) Wastewater Flow: GPD
(See note below, if applicable ❑) 1
�� XfA c=-:.—fI-1- (Repair)
Installation Requirements/Conditions Number of trenches l
Septic Tank Size gallons /0Q0 Exact length of each trench �i 6
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth of: 3y _2(9
Pump Requirements: ft. TDH vs.
Conditions:
(Trench bottoms shall be level to +/-1/4"
in all directions)
GPM
feet Trench Spacing: 2 Feet on Center
Soil Cover: 6 inches
inches (Maximum soil cover shall not exceed
36" above the trench bottom)
Aggregate Depth:
WATER LINES (IN(LUDING IRRIGATION) MUST BE LOFT. 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 specifled on the application. / accept the specifications ofthis 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
c,
Authorized State Agent a Date: /C. aG —
Construction Authorization Expiration Date: l/ to
HTE# IS" -S WO 8
Permit # :2 8 VIS
Harnett County .
Site Sketch
PROPERTY LOCATON: 4-14-
ISSUED T0:-..�,� �� c; c PPcs SUBDIVISIONLOT #
Authorized State Agent: / Date: �� lz�Lf
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