IPACOro - - 4- t�
HA. TT COUNTY HEALTH DEPART IT No ;
IMPROVEMENT PERMIT
Be it ordained by the Harnett County Board of Health as follows: Section III, Item B. "No Person shall begin construc-
tion 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) z �c New Installation \ Sceptic Tank
Property Location: SR #_1S H Repairs
p I� Nitrification Line
Subdivision
Tax ID
Number of Bedrooms Proposed:
Basement with Plumbing: El-"
Water Supply: L] Well d Public
Distance From Well:
ft.
Quadrant #
Lot Size: J
Garage: ❑
�j Community
Lot #
Following is the minimum specifications for sewage disposal system on above captioned property. Subject to
final approval.
Type of system: aj Conventional d Other
Size of tank:
Subsurface
Drainage Field
Septic Tank: gallons Pump Tank: gallons
No. of exact length width of depth of
ditches 3 of each ditch 1-3 3 ft. ditches ft. ditches 1y" 7 0 in.
French Drain Required:
Linear feet
This permit is subject to revocation if site
plans or intended use change.
Date:3
Signed. < f
Environmental Health Specialist
a
ID V 0 1 eey
105 --5 — -,)SiU
RAY "'-VTT COUNTY HEALTH DEPARTMENT
AUTx-JRIZATION TO CONST1aUC,
Authorization is hereby given to construct a wastewater system to the s ecifcations described by
Harnett County Health (Department, Improvement Permit #, Z -Z' . This
authorization shall be valid for a period not to exceed five (5) years from the date of issuance.
This authorization will be invalid if ownership, site plans, or intended use change.
1/"rPX"j 1/0- e/Z 7 - / f 7F
Name --�
Telephone
P- o�
Address --
/Slgl may c4re�- 1201-,> Property Location SR# Rod Name
Subdivision Lot # # Bedrooms Proposed Lot size
TYPE OF SYSTEM
[ New Installation [ I Repair [ Septic Tank [ Nitrificiation Lines
[ Conventional Other
[ ]Basement [ I With Plumbing[ ] Without Plumbing
Water Supply: [ ] Well [ -I<blic - Minimum Well Setback: Ft.
Septic Tank / Zoo Pump Chamber
NITRIFICATION FIELD SPECIFICATIONS
Number of fields Z # of lines per field J Length of lines j 3-3 Ft.
Width of ditches 3 fL Depth of ditches I ? = ZZ inches
French (Drain: Linear feet required (Depth of gravel
No wastewater system shall be covered or placed into use by any person until an
inspection by the Harnett County Health Department has determined that the system
has been installed according to the conditions of the Improvement Permit and that a
valid Operations Permit has been issued.
SiziAture of
Agent for Harnett County