IPAC RHTE# M -5-X11039— Harnett County Department of Public Health 29137
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: ki;> s 'PXU*. QD
ISSUED TO: Dv+s taa9Z CUQA1"N SUBDIVISION LOT #
NEW'W REPAIR ❑ XPANSION ❑
Type of Structure: SFP ,L H 'ice v 6
Proposed Wastewater System Type:'�LS'Vy REOUC;1 ON 3 Ew
Projected Daily Flow: A L4 GPD
Number of bedrooms: a Number of Occupants: L4 max
Basement ❑Yes �' No
Site Improvements required prior to Construction Authorization Issuance:
Pump Required: []Yes XNo ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community >L Public ❑ Well Distance from well feet
Permit conditions:
Permit valid for.
Five years
❑ No expiration
Authorized State Agent:: 7! S Date: � 1 `%I N-7 SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees `once of other permits. The permit holderonsible for checking with appropriate governing bodies in meeting their requirements. This
site is subject in revocation if the site plan, plat, or the intended use changes. Thelinmen Permit shall not be affected by a change in ownership of the sin. 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 cnnsWfh(In and installation requirements of Rules .1950, .1952..1954, .1955, .1956, .1957, .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. n
ISSUED T0: a 655 Cuwanro PROPERTY LOCATION: ylCAVa
SUBDIVISION LOT #
Facility Type: 5R-0 `l {Ls y 21(7 New ❑ Expansion ❑ Repair
Basement? ❑ Yes �tk No Basement Fixtures? ❑ Yes )K No
Type of Wastewater System" aS°f o REau c,\,, cis., Sys 76,4 (Initial) Wastewater Flow: a -"LO GPD
(See note below, if applicable ❑)
Conditions:
Trench Spacing: q Feet on Center
Soil Cover: C-10 inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
Aggregate Depth:
inches below pipe
inches above pipe
inches total
WATER LINES (IN(LUDING IRRIGATION) MUST BE LOFT. FROM ANY PART OF SEPTI( SYSTEM OR REPAIR AREA.
NO UTILITIES ALLOWED IN INITIAL OR REPAIR DRAIN FIELD AREA.
"If applicable: l understand the system type spedfed it different from the type specified on the application. / accept the spedfcafom of this permit
Owner/legal Representative Signature: Date:
This Construction Authoriaati "ea te rerontion if the site pian, 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 'em to comp ih the fstevisioms of the Laws and Rules for Sewage Treatment and Disposal and tothe Conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent: Q&15 Date: ) )'L 17
-oltruction Authorization Expiration Date: t 19 a"a
Z,s°Lo
QEDucT0,j Sy5i6+1 (Repair)
Installation Requirements/Conditions
Number of trenches Z -
Septic Tank Size � oo �J
gallons
Exact length of each trench u feet
Pump Tank Size
gallons
Trenches shall be installed on contour at a
Maximum Trench Depth of. 11 'a;), inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
Pump Requirements:
ft. TDH vs.
GPM
Conditions:
Trench Spacing: q Feet on Center
Soil Cover: C-10 inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
Aggregate Depth:
inches below pipe
inches above pipe
inches total
WATER LINES (IN(LUDING IRRIGATION) MUST BE LOFT. FROM ANY PART OF SEPTI( SYSTEM OR REPAIR AREA.
NO UTILITIES ALLOWED IN INITIAL OR REPAIR DRAIN FIELD AREA.
"If applicable: l understand the system type spedfed it different from the type specified on the application. / accept the spedfcafom of this permit
Owner/legal Representative Signature: Date:
This Construction Authoriaati "ea te rerontion if the site pian, 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 'em to comp ih the fstevisioms of the Laws and Rules for Sewage Treatment and Disposal and tothe Conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent: Q&15 Date: ) )'L 17
-oltruction Authorization Expiration Date: t 19 a"a
HTE# M' 5 - '-.-0 103 9, Permit #
Harnett County Department of Public Health
Site Sketch
PROPERTY LOCATON: ?"c,' vp&" 9,o
ISSUED TO: r SUBDIVISION LOT #
Authorized State Agent L,-;ESLi W y -50Q Date: 1T�7
Pcncawz '�D
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