HomeMy WebLinkAboutIPACHARY -T COUNTY HEALTH . , .
IMPROVEMENT PERMh 22100
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) �ts 5 V- o 9p u . L® EQ.n New Installation Septic Tank
Property Location: SR# I I 0,_,0 US LAD -1 0 Repairs 7Nitrification Line
Subdivision M4 -,m,,,- `LL V- o c. v__ Lot # 5
Tax ID # Quadrant #
Number of Bedrooms Proposed: �� wow Lot Size: -x-77 P, c --
Basement with Plumbing: Garage:
Water Supply: 71 Well Public Community
Distance From Well: l oa ft.
Following is the minimum specifications for sewage disposal system on above captioned property. Subject
to final approval.
Type of system:
Conventional 171 Other
Size of tank: Septic Tank: 1 o0o gallons Pump Tank: gallons
Subsurface No. of exact length width of
Drainage Field ditches 3 of each ditch '- O ft. ditches
French Drain Required: Linear feet
This permit is subject to revocation if site
plans or intended use change.
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Date: 8
Signed: �OL,Y ie�ksev��
ua Environmental Hea Specialist
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111 .11\l V 1i I 1 k,v UjN 1 Y DEPARTMENT OF PUBLIC HEALTH
AUI-TORTZATION TO CONST-TJCT
Authorization is hereby given to construct a wastewater system to the specifications described b
Harnett County Department of Public Health, Improvement Permit # Z pp S'
authorization shall be valid for a period not to exceed five (5) years from the date of issuance, This
This authorization will he invalid if ownership, site plans, or intended use change.
Name
Telephone#
PC lt>OJ�
Address
S
rropeny t,ocation SK#
Road Name
Subdivision Lot ## B
edrooms rop sed Lot Size
TYPE OF SYSTEM
New Installation [ ] Repair V] Septic Tank
Nitrification Lines
[, Conventional [ ] Other
[ ] Basement [ ] With Plumbing . [ ] Without Plumbing
Water Supply: [ ]well Public Water Supply Minimum Well Setback: Iz
pP y--___dPt.
Septic Tank lei gal Pump Chamber
gal
NITRIFICATION FIELD SPECIFICATIONS
Number of fields I # of lines per field _ Length of lines 5
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 by any person until an—inspection b
the,
Harnett County Health Department has determined that the system has been installed accordingto
the conditions of the Improvement Permit and that a valid Operations Permit has been issued.
Signature of Authorized Agent for ett County I