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IPACHARP "T COUNTY HEALTH DEPARTN `TT HTE#U.-5o(z •9• 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) CcN-xT . New Installation Septic Tank Repair Property Location: SR# gL9NL4. Q Nitrification Line Expansion Subdivision Lot #1A Tax ID# Quadrant # Number of Bedrooms Proposed: Lot Size: -.11 C-�C, Basement with Plumbing: Garage: Water Supply: 0 Well Public Community Distance From Well: Following is the minimum specifications for sewage disposal system on above captioned property. Subject to final approval. Type of system: 0 Conventional Other 9u m � o FNI Size of tank: Septic Tank: gallons Pump Tank: t ® ®b gallons Subsurface No. of exact length width of depth of Drainage Field ditches 5 1. of each ditch ft. ditches 3 ft. ditches 1 a in. French Drain Required: Linear feet Date: 3 15 7}� This permit is subject to revocation if site PERM I 5 YEARS FROM ABOVE DATE plans or intended use change. Signed : Environmental J1eahh Specialist '��'s�zjuo vPayS Pu rnP � QC1.ES5U2E. i't�.a. C� U 4-, R.h 5 e1AL1�yW 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 #—'j 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. � A 4KI- Z I Z } Name Telephone # Address Property Location SR# Road Name Subdivision Lot # # Bedroom roposed Lot Size TYPE OF SYSTEM ] New Installation [ ] Repair �q Septic Tank X] Nitrification Lines [ ] Conventional '] Other Q o me "�o ON S yz5 5;,� [ ] Basement [ ] With Plumbing [ ] Without Plumbing Water Supply: [ ] Well Septic Tank V O d C [Public Water Supply Minimum Well Setback: 1 O b Ft. gal Pump Chamber t D© p NITRIFICATION FIELD SPECIFICATIONS gal Number of fields i. # of lines per field 5 Length of lines 6® Ft. Width of ditches ft. Depth of ditches Ya, 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 a County K