Improvement permit for RepairHTE# RE POOL. Harnett County Department of Public Health
11-5- 1! tbO3 Improvement Permit 2 6 4 7 5
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: ~a\, ~ys C~S9ZOcai~S
ISSUED TO: Y~,S ~P"1y- VA t: SUBDIVISION LOT #
NEW ❑ REPAIR EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance: T
Type of Structure: `S F P O LS p CA. , a) G acz-ASE
Proposed Wastewater System T pe: Go N y 6,,r ip N A 1,
Projected Daily flow: 1-i O GPD
Number of bedrooms: 4 Number of Occupants: <Z,? max
Basement ❑Yes )0 No
Pump Required: ❑Yes ~K No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community ;K, Public ❑ Well Distance from well 100 feet Permit valid for: Five years
Permit conditions: ❑ No expiration
Authorized State Agent:: y C-'t-•S Date: ~2l~ I tl SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the issua f other permits. The permit holder is resp nsible 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 Improves 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: 1Z5 Q P% q )i N G PROPERTY LOCATION:
SUBDIVISION LOT #
Facility Type: Si`r' Oc~p,C,NC.~D GeQRrcP_ ❑ New ❑ Expansion Repair
Basement? ❑ Yes No Basement Fixtures? ❑ Yes )KI No
Type of Wastewater System**
(See note below, if applicable
C,c 1.41161,71 W rte! t, f.. (Repair)
Installation Requirements/Conditions
Number of trenches °-t
Septic Tank Size ~ r;),M gallons
Exact length of each trench IOC> feet
Pump Tank Size gallons
Trenches shall be installed on contour at a
Maximum Trench Depth of ` O-ajLA inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
Pump Requirements: ft. TDH vs.
GPM
Conditions: ~NS'SP.Ia-~fl-~a 1- eccl HEp~LTH 1J~PPr~L~N1~N
PR.X0617to ~rv5'sc~t_>.P,TtdeJ. see. crworrtcsrJS 5,-'
(Initial) Wastewater Flow: U'~ a GPD
Trench Spacing: Feet on Center
Soil Cover: 'R inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
6 inches below pipe
Aggregate Depth: r, inches above pipe
>STtt< 1 inches total
s-1 ~~Ga_u0\a6 S?~L,»,o ~4\w1
WATER LINES (IN(LUDING IRRIGATION) MUST BE LOFT. FROM ANY PART OF SEPTIC SYSTEM OR REPAIR AREA. ?-.r-q v%c*.P,~&t rs
NO UTILITIES ALLOWED IN INITIAL OR REPAIR DRAIN FIELD AREA.
**If applicable: l understand the sy stem type specified is different from the type specified on the application. / accept the specifications of this permit.
Owner/Legal Representative Signature: Date:
This Construction Authorization is subject Trrev on if the site fat, 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 s-kkw4 complian>c the P oi~4e s and Rules for Sewage Treatment and Disposal and to the conditions of this permit. SEE ATTACHED SITE SKETCH
Authorized State Agent: v v v ka~AS Date: ~ -j4 1)
Construe n Authorization Expiration Date: AY~ 16
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