OPHTE#I(Z --Z&14.y Harnett County Department of Public Health
PERMIT # 26-,81Operation Peemit 2 2 2 5 4
New Installation FA Septic Tank G d Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION; iti,i& k ` 44)
Name: (owner) 0044 Vol tiSUBDIVISION ~s llltge~ F ~ LOT # 82,
System Installer: Registration #
Basement with plumbing: El Garage Number of Bedrooms
Type of Water Supply: ❑ Community Cd Public ❑ Well Distance from well feet
System Type: Ald Types V and VI Systems expire in 5 years.
(In accordance with Table V a) Owner must contact Health Department 6 months prior to expiration for permit renewal.
This system has been installed in compliance with applicable North Carolina General Statutes, Rules for Sewage Treatment and Disposal, and all yonditions of the Improvement Permit and Construction Authorization.
PERMIT CONDITIONS:
1. Performance: System shall perform in accordance with Rule .1961.
11. Monitoring: As required by Rule .1961.
III. Maintenance: As required by Rule .1961. Other:
Subsurface system operator required? Yes ❑ No ❑
If yes, see attached sheet for additional operation conditions, maintenance and reporting.
IV. Operation:
V. Other:
❑ D-Box ❑ Pump ❑
Following are the specifications for the sewage disposal system on the above captioned property.
Type of system: L4' Conventional ❑ Other
Subsurface No. of exact length
Drainage Field ditches of each ditch 70 feet
French Drain Required: Linear feet
Alarm ❑ H20Line ❑
PWR Line
Septic Tank: 47(-~ `4 gallons Pump Tank: gallons
width of depth of
ditches 3 feet ditches Z t~
F inches
I Date 3- -7-12-
Authorized State gent &2