IPACHTE# 1 Zo Harnett County Department of Public Health
NEW 1Rr REPAIR ❑ EXPANSION ❑
Type of Structure:
Proposed Wastewater System Type: 2511%, f tf,
Projected Daily Flow: GPD
Number of bedrooms: Number of Occupants: max
Basement ❑Yes No
Pump Required: ❑Yes F-1 No ER/Ma be required based on final location and elevations of facilities
Type of Water Supply: El Community Public ❑ Well Distance from well feet
Permit conditions: . 9 _ ® a r ,9 rt
Permit valid for: 12 Five years
❑ No expiration
Authorized State Agent - C- Z-f!f2" Date: a 11`7 -11 SEE ATTACHED SITE SKETCH
The issuance of this permit by t4~fealth 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 a 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: Jg0t;
~SUBDIVISION LOT # Z
Facility Type: 2/New ;J Expansion ❑ Repair
Basement? ❑ Yes No Basement Fixtures? ❑ Yes P No
Type of Wastewater System" 7- /r' a- - ` yzel~ ,5 (Initial) Wastewater Flow: GPD -30 (See note below, if applicable
Z61
Installation Requirements/Conditions
Septic Tank Size 1006 gallons
Pump Tank Size gallons
Pump Requirements: ft. TDH vs.
Conditions: f~i i
Site Improvements required prior to Construction Authorization Issuance:
ff - (Repair)
Number of trenc es q
Exact length of each trench &0 feet
Trenches shall be installed on contour at a
Maximum Trench Depth of: 21 inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
_ GPM
Trench Spacing: Feet on Center
Soil Cover: inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
inches below pipe
Aggregate Depth: 2-- inches above pipe
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: 1 understand the system type speciled is different from the type specifyed on the app/icatiom / accept the .specifications of 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 ownershiD 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, SEE ATTACHED SITE SKETCH
-i /
Authorized State Ag f Date: '~r Z---4
Construction Authorization Expiration Date: -5--- ►2---1
HTE# Zkez,-O Permit # -2 'A'16
Harnett (county Department of Public Health
Site Sketch
. ►M0