IPAC RR - see Restoration through Christ filee< HARD 'T COUNTY HEALTH DEPARTM T 2 0 2 2 2
RV. 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) `t", L_ - zowag_ New Installation `Septic Tank
Property Location: SR# 1-4-01 PaHa sA 17) Repairs Nitrification Line
Subdivision
TaxID#
Number of Bedrooms Proposed:
Basement with Plumbing: 17 Garage:
Water Supply: 71 Well Public Community
Distance From Well: ft.
Lot #
Quadrant #
Lot Size:
I
Following is the minimum specifications for sewage disposal system on above captioned property. Subject
to final approval.
Type of system: 0 Conventional 0 Other
Size of tank: Septic Tank: gallons Pump Tank: 1 OoQ gallons
Subsurface No. of 6, C. exact length C. width of depth of
Drainage Field ditches of each ditch ft. ditches ft. ditches in.
French Drain Required: Linear feet
Date: CN~~~~~ -1 1,
This permit is subject to revocation if site Signed: ¢s (giv~¢ Tdk
plans or intended use change.
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onmental Health Specialist
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HAW,-''T COUNTY HEALTH DEPART ` -NT
AUT,I ...)RIZATj0N TO CONSTTZ, r
Authorization is hereby given to construct a wastewater
by Harnett County Health Department, Improvement Persystem mit # to the pew motions described
authorization shalt be valid for a period not to exceed eve (5) years This
This authorization will be invalid if ownership, site plans, or intended fuse chap da to of issuance.
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Address
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Property Location SR#
'ACA- ,
Road Name
Subdivision
Lot # # Bedrooms Proposed
TYPE OF SYSTEM
Lot Size
] New Installation [ ] Repair Septic Tank
[ ] Nitrification Lines
[ ] Conventional [ ] Other
[ ] Basement With plumbing [ ] Without Plumbing
Water Supply: [ ] Well public Water supply Minimum Well Setback:
C) Ft.
Septic Tank ~ Pump Chamber QQ d
~0j
NITIRFICATION FIELD SPECIFICATInVq
Number of fields x N
# of lines per field Length of lines
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 by any person until an inspection b the
Harnett County Health Department has determined that the system has been installed according to
the..Qonditi
ons of the Improvement Permit and that a valid Operations Permit has been issued.
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Signature of Authorized Agent for
iz~s
of Harnett
tI ~ ` I to Date