OP & IPAC^HARNETT COUNTY HEALTH DEP
ENVIRONMENTAL HEALTH SEN NO O 8 8 9 O
CERTIFICATE OF COMPLETION / OPERATIONAL PERMIT
Name: (owner) 5 a
mc
New Installation
Property Location: SR# 2n 3 � ❑ Repairs
Subdivision
Lot # —
TAX ID# Quadrant #
Contractor. -UC 1^a , 4e-� Registration#
Basement with Plumbing: ❑ Garage: ❑
Water Supply: ❑ Well X Public ❑ Community
Distance From Well: 4M A� ft.
$f Septic Tank
ffi Nitrification Line
Following are the specifications for the sewage disposal system on above captioned property.
Type of system: J4 Conventional ❑ Other
Size of tank: Septic Tank: gallons
Pump Tank: gallons
Subsurface No. of exact lengthwidth of depth of 2
Drainage Field ditches 3 of each ditch / SS ft. ditches — ft. ditches /�Y
in.
French Drain: Linear feet
Date: s 3
PERMITNO. t)44jg7
Inspected by::
Environmental Health Specialist
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HAI N OUNTY HEALTH DEPARTMENT 0 N o g g 48 7
IMPROVEMENT PERMIT
Be it ordained by the Harnett County Board of Health as follows: Section HI, Item B. 'NIo peon
rs
shall begin construction of any building at which a septic tank system is to be used for disposal n
sewage without first obtaining a written permit from the Harnett County Health Department".
i
Name: (owner) —kn aQ.. A At New Installation ff Septic Tank
Property Location: SR# 2U 3'S O Repairs Aft Nitrification Line
Subdivision
Lot #
Tax ID#
Quadrant #
Number of Bedrooms Proposed: 3 Lot Size:
Basement with Plumbing: O Garage: O
Water Supply; ❑ Well U Public ❑ Community
Distance From Well: /OD d3 ,a ft.
Following is the minimum specifications for sewage disposal system on above captioned
property. Subject to final approval.
Type of system: RL Conventional D Other
Size of tank: Septic Tank: -Jaj20 gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches_ of each ditch SSS ft. ditches ft, ditches -36 in.
French Drain required: Linear feet i
This permit is subject to revocation if site
Plans or intended use change.
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VOID AFTER 5 YEARS
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Date:
Signed:
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1 Health Specialist
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