IPAC RHTE# �s-s=3sasyl� Har,_.tt County Department of Public .,ealth 28150
hDrovement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: C'k I e kk 44.
ISSUED TO: SUBDIVISION LOT #
NEW Fr' REPAIR ❑ t EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: ,SF t� Cs 1 X b cl
Proposed Wastewater System Type: 0-S— ,t ,eco cb < u� f I �«
Projected Daily Flow: C/ e O GPD
Number of bedrooms: q Number of Occupants: max
Basement ❑Yes E910
Pump Required: ❑Yes ❑ No 1 i May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community ERIPublic ❑ Well Distance from well feet Permit valid for: ER-fiive years
Permit conditions: ❑ No expiration
Authorized State Agent::/.
�/i �.vr -- sem% Date: T l f 9 / l tt SEE ATTACHED SITE SKETCH
The issuance of this permit byte Heti alth 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 TO: PROPERTY LOCATION: /Ac' ke--, Ck.tpr`1 e-L,,cA X'6.
SUBDIVISION LOT #
Facility Type: 1�6ew ❑ Expansion ❑ Repair
Basement? ❑ Yes 2r No Basement Fixtures? ❑ Yes ❑ No
Type of Wastewater System** aj:2 9 tJQ ��-= �� �i/ � >~ (Initial) Wastewater Flow: GPD
(See note below, if applicable ❑)
' T,�Tom.` (Repair)
Installation Requirements/Conditions Number of trenches /
Septic Tank Size /000 gallons Exact length of each trench -700 feet Trench Spacing: Feet on Center
Pump Tank Size gallons Trenches shall be installed on contour at a Soil Cover: inches
Maximum Trench Depth of: i 8-a If 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:: �gj t C�1%�. 0� -f a Me e- if c,, -k, r, � pv="�' r inches total
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.
**If applicable: I understand the system type specified is different from the type specified on the applicatiom l accept the specircations o/ 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
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 )tt Al1ALHU) 1111 )IStIIM
C c'�f Z Z�1 f{
Authorized State Agent: ..�.� v..� � Date: 411
Construction Authorization Expiration Date: Zo
HTE# /S= f- 3S"a 8 N /�_ Permit # d 8 15-C
CountyHarnett r It • of Public Health
Site Slietch
PROPERTY LOCATON: At'4ew. C��� r' Cl,%Jl-ck lej.
ISSUED TO: f'1 rat C-IcNr SUBDIVISION LOT #
Authorized State Agent: 2-4� � g 7r / .,E' < Date:
C �e�n C C4. V.1'LK led,