IPAC�FA111� ` I .
Mxtl
♦ /;. ♦ ,, ,
Authorization is hereby given to construct a wastewater system to the specifications described by
Harnett County Health ]Department, Improvement Permit # 2 , This
authorization shall be valid for a period not to
exceed five (S) years from the elate of issuance,
This authorization wig he invalAd if ownership, site plans, or intended use change.
Name Teleph e #
A rldrecc
Property.LoC9
T77
/IQ �d
on SR# Road Name
LY_ L)ri
Lot # # Bedxoonr s Proposed Lot size
TYPE OF SYSTEM
( New Installation Re it /S ptic Tank
[ J Pa �C 1 p ]�N�triSciahon Lines
[ ] Conventional Other , -- 6, C 4:-y J - [ ]Basement [ JWM Plumbing [ ] Without Plumbing
Water Supply; [ ] Well [ nblic Minimum Well Setback: J"C) Ft.
Septic Tank f ,;; S -G Pump Chamber I G00
19111, 2101 1 Y 1 ► AL1
Number of fields - / # of lines per field 64�' Length of lines .? s" Ft.
Width of ditches , fL Depth of ditches , - 19 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
Mi valid Operations Permit has been issued. 11
- )_
of Aut orized Agent for Harnett County
Date