OPHTE#/Z-'s -M-5-7 Harnett County Department of Public Health
PERMIT # Z&B'd 0 erg ation Permit / 2 2 2 8 2
Eg New Installation Septic Tank EZ Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION:. nra~
Name: (owner) _ Ke-!~ = SUBDIVISION a,~ tT i d LOT # :3
System Installer: 5 Registration #
Basement with plumbing: ❑ Garage VP umber of Bedrooms --3
Type of Water Supply: ❑ Community uf~l dN~il Dista ce from well feet
System Type: Types V and VI Systems expire in 5 years.
(In accordance with Table V a) Owner must c ct Health Department 6 months prior to expiration for permit renewal.
This system has been installed in compliance with
?3.
Carolina General Statutes, Rules for Sewage Treatment a Disposal, and all conditions of the Improvement Permit and Construction Authorization.
4,06
PERMIT CONDITIONS:
1. Performance:
11. Monitoring:
III. Maintenance:
1`
System shall perform in accordance with Rule .1961.
As required by Rule .1961.
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 ❑ Alarm ❑ H20Line ❑ PWR Line
Following are the specifications for the sewa disposal system on the above captioned property.
Type of system: ❑ Conventional Other 752:) /~L t3b Sash Septic Tank: 100'0 gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches q of each ditch feet ditches feet ditches 2`1 inches
French Drain Required: Linear feet
;`U"171~r>
Authorized State A6nt = ---5 Date A'-1,
I ti~
12-5-28697 (1) 12-5-28697 (2)
4,4
12-5-28697 (3) 12-5-28697 (4) 12-5-28697 (5)
z
. ,f .rte ~ ti` u j• Mgt, i f
12-5-28697 (6) 12-5-28697 (7) 12-5-28697 (8) 12-5-28697 (9)
12-5-28697 (10)