OPHTE #- 5 - M16 a Ha,,,ett County Department of Publi, Health
PERMIT Operation Permit 22606
C2' New Installation C-'Septic Tank, 'Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION:
Name: (owner) SUBDIVISION 41 LOT #
System Installer: ` Registration #'
Basement with plumbing: ❑ Garage ❑ Number of Bedrooms
Type of Water Supply: ❑ Community Cl Public ❑ Well Distance from well feet's
System Type: IZ - -- g? Types V and VI Systems expire in 5 years.
Tabl
(In accordance with e 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 conditions of the Improvement Permit and Construction Authorization
PERMIT CONDITIONS:
I. 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 ❑ Alarm ❑ H12OLine ❑ PWR Line
Following are the specifications for the sewage disposal system on the above captioned property.
Type of system: ❑ Conventional X Other c Septic Tank: I6 0'0 gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches of each ditch 0 feet ditches feet ditches LQ inches
French Drain Required: Linear feet
Authorized State Agent �'�f Date `--
HTE# 4440 Ha...ett County Department of Publi, dealth
PERMIT # Operation Permit '12 1191 01
E311� New Installation 0' Septic Tank ❑F' Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION:
Name: (owner) dv s1
SUBDIVISION LOT # ';Z
Registration #
System Installer: 111.1 ', Al 441�140_1'1'1'
"-' er- I '
Basement with plumbing: El Garage 0 Number of Bedrooms
Type of Water Supply: ❑ Community eiublic ❑ Well Distance from well / ?I feet
System Type: 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 conditions of the Improvement Permit and Construction Authorization.
PERMIT CONDITIONS:
I. Performance: System shall perform in accordance with Rule .1961.
11. Monitoring: As required by Rule .1961.
111. 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:
R11111 D-Box ❑ Pump ❑ —Alarm ❑ H20Line ❑ PWR Line
Following are the specifications for the sewage disposal system on the boye captioned property.
Type of system: ❑ Conventional Fv7l°Other :L ' — Septic Tank: gallons Pump Tank: — gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches of each ditch 4' feet ditches
feet ditches inches
French Drain Required: Linear feet
Authorized State Agent f:;,' Date A/
77