IPACHARNETT UNTY HEALTH DEPARTMENT iv 18796
IMPROVEMENT PERMIT
Be it ordained by the Harnett County Board of Health as follows: Section 111, 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) 0-"New Installation 0-Se Itic Tank
Property Location: SR# Z%:�7Y 6�1_� 5 Repairs :-Nitrification Line
Subdivision 42-M. 4.�M Lot # Z_
r
Tax ID # Quadrant #
Number of Bedrooms Proposed: Lot Size: 144e�
Basement with Plumbing:
Water Supply: E] Well
Distance From Well:
N,
ft.
Garage: EJ
Community
Following is the minimum specifications for sewage disposal system on above captioned property. Subject to
final approval.
Type of system: UConventional EJ Other
Size of tank:
Subsurface
Drainage Field
French Drain F
This prerrnit is sul
plans or intended
Ji
Septic Tank: 10070 gallons Pump Tank: — gallons
No. of exact length width of depth of
es of each ditch 133 ft. ditches ft. ditches /6-1 � 7in
,d Linear feet
Date: -5-1-1 -0
if site Signed: 4:;__ c!fJ!L?!!v
Environmental Health Specialist
4f)
P1 1�33
'o2- S`= Via ?
103M K114 -1 M R M
IM
Authorization is hereby given to construct a wastewater system o the �sn ecifcations described by
Harnett County Health Department, Improvement Perm This
authorization shall be valid for a period not to exceed five (S) years from the date of issuance.
This authorization will be invalid if ownership, site plans, or intended use change.
r /j . C
2 '3 `6
of # # Bedrooms Proposed Lot size
TYPE OF SYSTEM
[ 414ew Installation [ Repair [ ptic Tank [ Nitrification Lines
[ ouventioual Other.
[ ] Basement [ l With Plumbing [ ] Without Plumbing
Water Supply: ( ell [ ] Public - Minimum Well Setback: Ft.
NITRIFICATION FIELD SPECIFICATIONS
Number of fields # of fines per field Length of lines 133 Ft.
Width of ditches fl. Depth of ditches inches
x ^y
French Drain: Linear feet required Depth of gravel
No wastewater system shall be covered or placed into use-byany 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
valid Overations Permit has been issued.
of Authorized Agent for Harnett County
Date