OP RHTE# iz''Sy- 2- r31 i3 Harnett County Departmen
PERMIT # 7- I-Laq er
0 p ation P
E / New Installation GJ
PROPERTY LOCATIO
Name: (owner) ,z.C% 4-2u �_ SUBDIVISION
System Installer: C Registration
Basement with plumbing: ❑ Garage YNumber of�Be�dfooms Z-
Type of Water Supply: El Community VPublic ER Well Distance from well
System Type: 2:0>0t.Z7x, --4 7 y 6 Types V a
(in accordance with Table V a) Owner must contact Health Del
This system has been installed in compliance with applicable North Carolina General Statutes, Rules for Sewage Treatment and
rmit �/ 22464
Septic Tank Ldt Nitrification Line ❑ Repair ❑ Expansion
LOT #_
feet
Systems expire in 5 years.
ant 6 months prior to expiration for permit renewal.
all conditions of the Imarovement Permit and Construction Authorization.
PERMIT CONDITIONS: ff
I. Performance: System shall perform in accordance with Rule .I 61!
IL Monitoring: As required by Rule .1961.
III. Maintenance: As required by Rule .1961. Other:
Subsurface system operator required? o
If yes, see attached she a ditional operation conditions, maintenance and reporting.
IV. Operation:
V. Other:
❑
D -Box
❑ Pump ❑
Alarm ❑ H2O1-ine ❑ PWR Line
Following are the specifications for
the sewa a disposal system on the above captioned property.
Type of system:
❑ Conventional
Eir Other 9.5 -0/- 10 t
Septic Tank: /000 gallons Pump Tank: gallons
Subsurface
No. of
exact length
width of depth of
Drainage Field
ditches
L of each ditch ) 0 y feet
ditches 3 feet ditches Z L4- -1 1 inches
French Drain Required: Linear feet
Authorized State Ag nt C Date