OPHARNETT COUNTY HEALTH DEPAR'T' No- 1 5 3 7 8
ENVIRONMENTAL HEALTH SECTION
OPERATIONS PERMF,"'
Name: (owner) ti 1~1C L_ t>~~ fiats 1 New Installation Septic Tank
Property Location: SR# " s Zn Repairs Nitrification Line
Subdivision 1 a,;, ' t,a~o J - Lot # 5
TAX ID# Quadrant # _
Contractor:. 15 €`t L. Registration #
Basement with Plumbing: Garage: [3
Water Supply: ❑ Well Public d Community
Distance From Well: cx-°) ft.
Following are the specifications for the sewage disposal system on above captioned property
type of system: Conventional ❑ Other
Size of tank: Septic Tank: 10C Q gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches _ of each ditch 25 ft. ditches 3 ft. ditches ` . in.
French Drain: Linear feet
PERMIT NO. _950
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