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IPAC RHTE# 15-5--5-116409— Harnett County Department of Public Health 28766 Improvement Permit A building permit cannot be issued with only an Improvement Permit PROPERTY LOCATION: W a ^a lzDFo os Q2 ISSUED TO: x, KSIN F i-lC)Mf-5 SUBDIVISION WP IVVc Gpacw6 LOT # 1 �s NEW4 REPAIR ❑ E SION ❑ Site Improvements required prior to Construction Authorization Issuance: Type of Structure: 5 17-0 k9 n Proposed Wastewater System Type: 9ZT0 vGt ca.aa ,aS^ Projected Daily Flow: L-A 3O GPD `� Number of bedrooms: N Number of Occupants: _ iLmax Basement ❑Yes '9�No Pump Required: []Yes 2AkNo El May be required based on final location and elevations of facilities Type of Water Supply: ❑ Community � Public ❑ Well Distance from well j on feet Permit valid for. >Five years Permit conditions: ❑ No expiration Authorized State Agent: ��\`\�¢El— Date: 10 1 b SEE ATTACHED SITE SKETCH The issuance of this permit by the Health Department in no way guarantees the issulln`of other permits The permit hold r u res onsible 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, .1953, .1954, .1955, AM, .1957, .1958. and .1959 are incorporated by references into this permit and shall be met Systems shall be installed in accordance with the atrached system layout ISSUED TO: H "T') Q)a�1SE ids S PROPERTY LOCATION: Ws r�F—flvv(��v�'� �Qr- SC� CsaAti.D SUBDIVISION AtNyt QyacJ`/E LOT # \r - New Type: New ❑ Expansion ❑ Repair Basement? ❑ Yes -'�R No Base�mf nt Fixtures? El Yes � No Type of Wastewater System** `QS Lo P,\Cz'-s t 0 Li g 15�sE7e- (Initial) Wastewater Flow: �� GPD (See note below, if applicable ❑) TVAY ) 0 1 e, (Repair) Installation Requirements/Conditions Number of trenches 1 Septic Tank Size l © O gallons Exact length of each trench Qy 0 feet Pump Tank Size gallons Trenches shall be installed on contour at a Maximum Trench Depth of I' 36 inches (Trench bottoms shall be level to +/-1/4" in all directions) Pump Requirements: ft. TON vs. GPM Conditions: Trench Spacin : �) 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 IOFT. 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 ryrtem type rpeciffed it different from the type rpeciled on the application. / accept the rpecifcationr of thir pem/it. Signature: Date: This Construction Authomatiomirw " o revocation if the site plan, plat at the intended use changes. The Construction Authorization shall not be transferred when there u a change in ownership of the site. This Construction Authorization is subject�o complian a ions of the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH Authorized State Agent: Date: Authorization Expiration Date: HTE# i5 -S 3ZCk,0Q. Permit # b -C Harnett County Depailment of Public Health Site Sketch PROPERTY LO(ATON: WIN�,Csx=ocr Q—)a- ISSUED TO: 0 N5 � S "0,-)65 SUBDIVISION LOT # Authorized State Agent Date: -3 �i