OPHTE #- `Bg+ Harnett County Department of Public Health
PERMIT 7 u ...Operation Permit 22487
13 /New Installation G 4Septic Tank 125' Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION:. ,. / -1'L-a ytl� i f-t• rO
Name: (owner) SUBDIVISION i a "s d 14,z LOT #
System Installer: _" � Registration #
Basement with plumbing: ❑ Garage [3 tuber of Bedrooms
Type of Water Supply: ❑ Community LJ Public ❑ Well Distance from well feet
System Type: 7, .e c; '' es V and VI Systems expire in 5 years.
(In accordance with Table V a) O�rner must contact Ith Department 6 months prior to expiration for permit renewal.
This system has been installed in compliance with applicable No Carolid' Y5er� Statutes,RRules for Sewage Treatment d Disposal, and all conditions of the Improvement Permit and Construction Authorization.
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9
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PERMIT CONDITIONS:
I. Performance: System shall perform in accordance with Rule .1961.
II. Monitoring: As required by Rule .1961. OUT-
Ill. Maintenance: As required by Rule .1961. Other:
Subsurface system operator required? Yes ❑ No ❑'►t -1� S
If yes, see attached sheet for additional operation conditions, maintenance and reporting.
IV. Operation:
V. Other:
❑ D -Box ❑ Pump ❑ Alarm ❑ H2OLine ❑ PWR Line
Following are the specifications for the seewwa$e disposal system on the above captioned property.
Type of system: El Conventional L3` Other Septic Tank: `' w gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches of each ditch f feet ditches feet ditches G'''t inches
French Drain Required: Linear feet
Date
Authorized State Agee 6 ' t
r
l�
W
12 -5 -29350 (1)
12 -5 -29350 (2)
12 -5 -29350 (3)
12 -5 -29350 (4)
12 -5 -29350 (5)