OP (could not sign off in hte due to o/s fees per j brock)HTE# 0`}-J_ kkXZ7 Harnett County Department of Public Health 2 0 6 9 0
PERMIT # Zr9 5'1 Aeration Permit
New Installation 2" Septic Tank El Repair ❑ Nitrification Line ❑ Expansion
PROPERTY LOCATION: Cr~r-rtl ~~r~
Name: (owner) oo v.,.~ Cara c SUBDIVISION LOT #
System Installer. _ G__r'i-,,,~ apt Registration #
Basement with plumbing: O Garage El ~Ymber of Bedrooms
Type of Water Supply: ❑ Community E? Public ❑ Well Distance from well 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.
finis 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,
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PERMIT CONDITIONS: y c t Uz;, Act
Performance: System shall perform in accordance with Rule .1961.
Monitoring: As required by Rule .1961.
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.
Following are the specifications for the sewage disposal system on the above captioned property.
Type of system: ❑ Conventional ❑ Other
Subsurface No. of exact length
Drainage Field ditches of each ditch feet
Septic Tank: /d() O gallons Pump Tank: gallons
width of depth of
ditches fppt ditrha< ;.r6e
rent rain Required:
lin
ar feet
Authorized State Agent
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