OPHTE# /'Z.`1_b_n06'd_ Harnett County Department of Public Health
PERMIT # Operation Pe it 2 2 2 9 4
5d 5 New Installation Septic Ta k d "Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION. 1W4
Name: (owner) SUBDIVISION LOT # 13
System Installer: 9%01-4-10 P _ Registration #
Basement with plumbing: ❑ Garage V public of Bedrooms
Type of Water Supply: ❑ Community l~' Public ❑ Well Distance from well feet
System Type: 251 c.a241-3 6 - e Types V and VI Syste s expire m 5 years.
(In accordance with Table V a) Owner must contact Health Department 6 onths prior to expiration for permit renewal.
This system has been installed in compliance with applicable North C olina General Statutes, Rules for Sewage Treatment and Disposal, and al conditions of the improvement Permit and Construction Authorization.
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10'
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PERMIT CONDITIONS:
1. Performance: System shall perform in accordance with Rule .1961.
II. 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 ❑
Alarm ❑ H20Line ❑ PWR Line
Following are the specifications for the sews disposal system on the above captioned property
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Type of system:
Other
❑ Conventional ER
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ump
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eptic Tank: f
Subsurface
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exact length
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width of depth of
et ditches inches
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Drainage Field
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French Drain Required: Linear feet
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Authorized State A
ry v
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12-5-29005 (4) 12-5-29005 (5) 12-5-29005 (6)
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12-5-29005 (7)
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12-5-29005 (8)
12-5-29005 (1)