IPAC RRRRRRRE 1ETT COUNTY HEALTH DEPAR ?ENT
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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 Heal h De
Name: (owner) New Installation Septic Tank Repair
Property Location: SR# Nitrification Line Expansion
Subdivision C-k %n,N j e- p's>r-- S Lot #
Tax ID# Quadrant #
Number of Bedrooms Proposed : 3a. x K0 7C3 ~-R cf Lot Size: c '(i /1---C
Basement with Plumbing: Garage: J c o "i , ] r, fib, 1'1(-d 94-0
Water Supply: Well P Community (XI o- pq,,, ~ t>t~
Distance From Well: 1 o r ft.
Following is the minimum specifications for sewage disposal system on above captioned property.
Subject to final approval.
Type of system: Conventional Other ~n rr''^
Size of tank: Septic Tank: 1030
Subsurface No. of
Drainage Field ditches
French Drain Required:
gallons Pump Tank: gallons
exact length width of
ft. of each ditch ft. ditches `3 ft.
Linear feet
depth of (-v-A )k
ditches in.
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Date: 0 ~ ° ~(-6 C o -cxl - 0
PERMIT EXPIRES 5 YEARS FROM ABOVE DATE
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Signed : Q, i
vironmental Health Specialist
This permit is subject to revocation if site
plans intendgd use change. t L A ~i-_
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5-50-0 1,X e& R_ A UTI-IORIZATION 1T0 CC~-NT r utsL1L HEALTH
S
TRUCT
Authorization is hereby given to construct a wastewater system to the s ecifications desc
Harnett County Department of Public Health, improvement permit nbed T
authorization shall be valid for a period not to exceed five years from t to Of iss
This
uance..
This authorization hill be invalid if Ownership, szteplans,ar intended afse change.
Name
Addi ess
Telephone
Jl .
Prop rly Location SR#
A Road Name
CWLAI ~AJr' 4 , ( k., ^
r A ~-G)
Subdivision Lot # 9 Bedrooms Proposed
Lot size
TYPE OF SYSTEM
New Installation { j Repair Septic Tank
XNitrificatan Lines
[ ] Conventional by they V t
[ ] Basement With Plumbing . [ ] Without Plumbing
Water Supply:. [ ) Well > TPublic Water Supply Minimum Well Setback: 643 Ft.
Septic Tank 0 gal Pump Chamber ' C~Op
gal
NITRIFICATION FIELD SPECIFICATIONS
Number of fields 1 # of lines per field j
Length of lines
Ft.
Width of ditches 3 ft. Depth of ditches inches
French Drain: Linear feet required Depth of gravel
No wastewater system shall be covered or placed into use b any person
ori Harnett County Health Department has determined that the system has been installed accordin the
the conditions of the Improvement Permit and that a valid Operations Permit has been issued. g to
Sign
of A>>thnri-rl A. 7--1,____
b,-- - --~L %-UU11ly
Date