IPACHARNETT COUNTY HEALTH DEPARTMENT
HTE ~~r- s ~►a. IMPROVEMENT PERMIT 9
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) Rco s ')iA *Ng-' New Installation Septic Tank
Property Location: SR# C lip sew L g z Repairs l Nitrification Line
Subdivision Lot #
Tax ID # _ Quadrant #
Number of Bedrooms Proposed: W- Lot Size:
Basement with Plumbing: Garage:
Water Supply: I Well Public Community
Distance From Well: JC> ft.
Following is the minimum specifications for sewage disposal system on above captioned property. Subject
to final approval.
Type of system: 'A Conventional
71 Other
Size of tank: Septic Tank:10~ gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches_ I~_ of each ditch 100 ft. ditches _3 ft. ditches iL4 in.
French Drain Required: --------Linear feet
Dater Oy
This permit is subject to revocation if site • Signed: R oi,~a
plans or intended use change.
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HARNETT COUNTY DEPARTMENT OF PUBLIC HEALTH
AUTHORIZATION TO CONSTRUCT
Authorization is hereby given to construct a wastewater system to the specifications described by
Harnett County Department of Public Health, Improvement Permit # aoC ~Icl 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.
Name
Nom)
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Telephone #
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Address
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Property Location SR#
Road Name
Subdrvision L ~ ~ ~C/
Lot # # Bedrooms Proposed Lot Size
TYPE OF SYSTEM
New Installation [ ] Repair Septic Tank ~X] Nitrification Lines
Conventional [ ] Other
[ ] Basement With Plumbing [ ] Without Plumbing
Water Supply: [ ] Well Public Water Supply Minimum Well Setback: } Ft.
Septic Tank t(X')(7)
gal Pump Chamber
NITRIFICATION FIELD SPECIFICATIONS
gal
Number of fields I # of lines per field ~N Length of lines C C)(~) Ft.
Width of ditches fl. Depth of ditches 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.
Signature of Authorized Agent for
92-5
County
x/1616