OPHTE# a9- J-= 2185-/ Harnett County Department of Public Health 2 0 7 0 0
PERMIT # c2 S3 I'3 Operation PPerm~it
f9' Iew Installation is )eptlc Tank ❑ Repair E9--kitrification Line ❑ Expansion
PROPERTY LOCATION: l~ as a, 1.
Name: (owner) ~cy.v4S Illzon SUBDIVISION LOT #
System Installer: (3S ~ ► ckI%Acf Registration #
Basement with plumbing: ❑ Garage ❑ Number of Bedrooms
Type of Water Supply: ❑ Community Public ❑ Well Distance from well feet JT7~1 - ~)C
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.
gnu >pam nas peen mstaieo in compliance vnm applicable North Carolma General Statutes, Rules for Sewage Treatment and Disposal, and all conditions of the Improvement Permit and Construction Authorization
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PERMIT rONDITIONC-
I. 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.
Following are the specifications for the sewage disposaj system on the above c tipped property.
Type of system: ❑ Conventional Other yluyt) {d (Z ~Septic Tank: 600 gallons Pump sank gallons
Subsurface No. of exact length G t) width of depth of
Drainage field ditches of each ditch feet ditches feet ditches l inches
french Drain Required: Linear feet
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