OPHTE#- 0 -s =Z-z3111 Harnett County Department of Public Health 2 0 8 8 0
PERMIT / Operation Flegbit
L~ New Installation E~ Septic Tank 1:1 Repair /Witrification Line El Expansion
PROPERTY LOCATION: JI a
Name: (owner) SUBDIVISION LOT # --?D
System Installer: J'N -S Registration #
Basement with plumbing: ❑ Garage umber of Bedrooms -3
Type of Water Supply: ❑ Community Public ❑ Well Distance from well feet
System Type: Z:5--&) Zf T_vv; La?3 SrAmn..- Toot Tc G EZ Types V and VI Systems expire in 5 years.
(In accordance with Table V a) Owner must tract Healt art s rior to expiration for permit renewal.
This system has been installed in compliance with applicable North Car liltd~l Statutes, Rules for Sewage Treatment and Disposal, and all conditions of the Improvement Permit and Construction Authorization.
t Y ~F-
11 5710
1
.0
u
~~c~t %
a 1J A-11
'
N0 t JA/L L:r1 G
r
r1!57,q-/) 47" 5,fH`
tJ~~-t-ZG J~-5 1J`L7rD
/3r Js r; A
TC
LJA
-
)t UAt6
IDZOd7
y
stw % .
PERMIT CONDITIONS:
1. Performance:
II. Monitoring:
III. Maintenance:
System shall perform in accordance with Rule .1961.
As required by Rule .1961.
As required by Rule .1961. Other.
IV. Operation:
V. Other.
Subsurface system operator required? Yes ❑ No ❑
If yes, see attached sheet for additional operation conditions, maintenance and reporting.
Following are the specifications for the sew We disposal system on the above captioned property.
Type of system: ❑ Conventional Other 1$016 PcRaOCn .5c fra,_ Septic Tank: ,/DO(~ gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of
Drainage field ditches of each ditch- feet ditches- feet ditches Iginches
French Drain Required: Linear feet
Authorized State Ag t Date /tL'7j -d 1
41{
A-1
s4
ILI
All
$ ,V{ 4, ~ II
yp " .
C
;j
t w t 41" ~
.Y
1 I
ool~
bf
T~.
i r
k
d
<P ~
k
rEa
j }
.s
E...
gyn..
ad:
~
#
ss
~ h P
4TT
ec ?
1, .
e _E
'bw; rt~ w'l
x
kt ~ ~
x
p ~x
J
t
4r
y
3 a v'.~ a
~
~•ra
' •cf
3
Sr
Y~
b
1
c w' S
p ow -
I
f
1 d ~i
r gas. a#
K ~n' b
Z ~
At4
~ X
k ~
x ~
4 F
r:4 "t
~ s
1`a i;Fe
f l• ''11 }
KIP! Y a S.
'r
ITT
r
P
A
P
:
I
I
~
rig
t
~ra
An
aw "A
fl
$ a ,
t.
2L,,.
t ~
1
To
't