IPAC RHar.,-tt County Department of Public .iealth 27940
Improvement Permit
A building permit cannot be issued with only an Improvemer}t,Permit
PROPERTY LOCATION:
ISSUED T0: ms' SUBDIVISION C�4,w�a LOT #
NEW,X REPAIR 60.E NON ❑ r Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: 5 �} i-bA'6`�1�
Proposed Wastewater System Type: Vt3 Giau-,� \D -,J
Projected Daily Flow: u GPD
Number of bedrooms: ' Number of Occupants: max
Basement ❑Yes No
Pump Required: ❑Yes >< No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community XPublic ❑ Well Distance from well 1 CC) feet Permit valid for: Five years
Permit conditions: No expiration
Authorized State Agent:: Date: r. SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the ce of other permits. The permit holder is t sponsible for checking with appropriate governing bodies in meeting their requirements. This
site is subject to revocation if the site plan, plat, or the intended u's8—cha a& 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 D''' a and to co this p
2—Gvi��a �1-7� IIS ri5
Construction -A -ft
Reauired 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: H wv oczS PROPERTY LOCATION: ocs Q
4 sSUBDIVISION 3 P, rm o t4fi LOT #
Facility Type: S�SJ '�X New ❑ Expansion ❑ Repair
Basement? ❑ Yes )� No Basement Fixtures? ❑ Yes X No UNQ
Type of Wastewater System** D—:; l'/O n v E' \ 0 N '525 —IG -m (Initial) Wastewater Flow: GPD
(See note below, if applicable ❑) o
� (/,3 i�y(�� "0t'1 (Repair)
Installation Requirements/Conditions Number of trenches � t''t'
Septic Tank Size 10 0 Q gallons Exact length of each trench �-d feet Trench Spacing: Feet on Center
Pump Tank Size gallons Trenches shall be installed on contour at a Soil Cover: G M T`8 inches
Maximum Trench Depth of. V% -3O 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
Aggregate Depth: inches above pipe
Conditions: inches total
WATER LINES (INCLUDING IRRIGATION) MUST BE LOFT. 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 speciped on the application. / accept the specifIcations of this permit.
Owner/Legal ReprumiLtive Signature: Date:
This Construction Authorization is subject to on if the site 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 to compliance the p�' ns of t ws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Ag Date: 13 11
ct, 4,s6JD1 2) -7 strue Authorization Expiration Date: C
HTE# Permit # Q-:"-) '1 li Q
Harnett Connty Department ® Public Health
Site Sketch
ISSUED TO:
Authorized State Agent:
PROPERTY LOCATON: Doc,'s Q-1)
SUBDIVISION 0 P% t-vcNvj m-1 LOT #
((DL, 4C-,2 -TOLV-'cW L�)F Date:
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