Voided IPAC due to new soil evalHARD 'T COUNTY HEALTH DEPARTNf 'T
HTE#O~- SJ3 C a sI G
IMPROVEMENT PERMIT 2 2 7 01
Be it ordained by the Harnett County Board of Health as follows: Section III, Item B. "No person shall begin
construction of any building at which a septic tank system is to be used for disposal of sewage without first obtaining a written
permit from the Harnett County Health Department."
Name: (owner) 0~11 L^ C~„ j New Installatiory Septic Tank Repair ❑
Property Location: SR# Nitrification Line ~0 Expansion ❑
Subdivision 01 ~ \-c Lot # E
Tax ID# Quadrant #
Number of Bedrooms Proposed : a X 69 Lot Size: S2 n C-
Basement with Plumbing: ❑ Garage: ;N'~ 2' N3
Water Supply: ❑ Well 0 Public ❑ Community ~T
Distance From Well: S-:5 ft.
Following is the minimum specifications for sewage disposa system on above captioned property.
Subject to final approval.
Type of system: 0 Conventional ❑ Other
Size of tank: Septic Tank: I X30 gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches ft. of each ditch ft. ditches _ft. dic hes pt in.
French Drain Required:
This p rmit is subject to revocation if site
pkans or intended use change.
t\-.4
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Linear feet
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Date: 'I ~ - 0~-
PERMIT EXPIRES 5 YEARS FROM ABOVE DATE
Signed :
Health Sneciali
o' 3 L, FIB„
r~
F/40
HARNETT COUNTY DEPARTMENT OF PUBLIC HEALTH
AL'"NORIZATION TO CONS --)-UCT
Authorization is hereby given to construct a wastewater system to the specifications described b
Harnett County Department of Public Health, Improvement Permit # ,_-,"0o C aS y~_ Y
authorization shall be valid for a period not to exceed five (5) years from the date of issuance. 'This
This authorization will be invalid if on nership, site plans, or intended use change.
Name,
Ir Telephone #
Address
Property Location SR#
Road Name
011 t 0_31,4 f 1 SO-WGa
Subdivision Lot # # Bedrooms Proposed
Lot Size
TYPE OF SYSTEM
>J' New Installation [ ] Repair Septic Tank N'Nitrification Lines
X-Conventional [ ] Other
[ ] Basement With Plumbing [ ) Without Plumbing
Water Supply: [ ] Well 'Public Water Supply Minimum Well Setback:
_.50
__Ft.
Septic Tank gal Pump Chamber
gal
NITRIFICATION FIELD SPECIFICATIONS
Number of fields # of lines per field ( Length of lines 7 J
Ft.
Width of ditches ft. Depth of ditches inches
French Drain: Linear feet required Depth of gravel
No wastewater system shall be covered or placed into use b any person Harnett County Health Department has determined that the system has been installed acco ding the
the conditions of the Improvement Permit and that a valid Operations Permit has been issued.
Si
n U) aA- 9_j
Authorized Agent for Harn
-~-f 0~-
~LL ~-VlL11Ly
Date
Initial Application Date: Application # MAJ
COUNTY OF HARNETT LAND USE APPLICATION
Central Permitting 102 E. Front Street, Lillington, NC 27546 Phone: (910) 893-4759 Fax: (910) 893-2793
LANDOWNER: 3 QO K t; Mailing Address: K68 0f • yC
City: C T 4 9 ~~w State: ~V Zip: 21311 Phone p~O f-t L 3 f Z
APPLICANT: et.nl 1441J6-Aj Cf(°° 4(10e (t""Clr Mailing Address: ~L2- f 2A0 Cu0
E`; yr C CA State: N c Zip:2O . ~ Phone Q / 91t 7 731
~
City: Y
PROPERTY LOCATION: SR /009
SR Name:
C y r/ 1-S C 94 2 e-k 40
Address: °i
C /1XX-r
CkoICc
SCR.. t4 c. 2832-4
Parcel: 0
PIN: - 1
.
Zoning:
Subdivision: ^
Loll Lot Size:
Flood Plain:
Panel: n
Watershed:
' It
Deed Book/Page: L-+
Plat Book/Page: f
an
DIRECTIONS T THE PROPERTY FROM LILLI
NGTON: 2 'r
_
2 ce 44 A f ~f• . Lt At. C/pwC
A& /41-4.C
IT 4 6 AI
c-/ 0.1 c It 6 A Ayo 2 oh i .-Fs c d
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Lf J-- /
I
PROPOSED USE: A o Uu,-AK I(L~A A A-M 1 "C-
9 Sg. Family Dwelling (Size 3 2 x ) # of Bedrooms ~ # Baths 3 Basement (w/wo bath) Gara Deck
❑ Multi-Family Dwelling No. Units No. Bedrooms/Unit
,rte
❑ Manufactured Home (Size x) # of Bedrooms Garage
Deck
Number of persons per household .f
'A
7
2
- '\--fC IC'OA a-4 A
C 60
Business Sq. Ft. Retail Space Type
❑
-
-
❑ Industry Sq. Ft. Type
❑ Church Seating Capacity Kitchen
C~
e
❑ Home Occupation (Size x# Rooms Use
Additional Information: `
❑ Accessory Building (Size x ) Use
❑ Addition to Existing Building (Size x~ Use
❑ Other
Additional Information:
Water Supply: County U Well (No. dwellings Other
Environmental Health Site Visit Date:
Sewage Supply: New Septic Tank Existing Septic Tank County Sewer Other
Erosion & Sedimentation Control Plan Required? YES NO
i
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b
? YES
'
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ns a manu
acture
ome Win
iv
Property owner of this tract of land own land that conta
trac
ste
a
ove
e hundre
feet (500
) o
Structures on this tract of land: Single family dwellings
anu a
ctur d es
Other (specify)
Required Residential Property Line Setbacks.,
rr
MFrriUrh r
Actual
Front 35 _
_GJPJdL -ow t
pt
Rear 25
f "o
Side 10
Corner 20 t o o
Nearest Building 10 /00
If permits are granted I agree to conform to all ordinances and the laws of the State of North Carolina regulating such work and the specifications or
plans submitted. I y swear that the foregoing statements are accurate and correct to the best of my knowledge.
Signature of Owner or Owner's Agent Date
**This application expires 6 months from the initial date if no permits have been issued**
A RECORDED SURVEY PLAT AND RECORDED DEED ARE REQUIRED WHEN APPLYING FOR A LAND USE APPLICATION
06/04
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