OPHTE#D9 -s - 2z:Z-rD Harnett County Department of Public Health 2 0 8 8 8
PERMIT # Z!5y 3 2 2 /New Pe mat
/Nitrification New Installation Septic Tank ❑ Repair Line ❑ Expansion
PROPERTY LOCATION:
Name: (owner)e.~,~~ ~"airas~ SUBDIVISION LOT
System Installer: Therms Gvon~,c Registration #
Basement with plumbing. ❑ Garage ❑ umber of Bedrooms .3
Type of Water Supply: ❑ Community v Public ❑ Well Distance from well feet
System Type: ZIM G WZ- G G Types V and VI Systems expire in 5 years.
(In accordance with Table V a) Owner must co ct Health Department 6 months prior to expiration for permit renewal.
uos srsrem nas peen uuianeu in cumpoance wan appucame norm carotma uenerai 7tatutes, naves for sewage treatment and
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PFRMIT ('001 MV-
and and all conditions of the Improvement Permit and Construction Authorization
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1. Performance:
11. Monitoring:
III. Maintenance:
IV. Operation:
V. Other
System shall perform in accordance with Rule .1961.
As required by Rule .1961.
As required by Rule .1961. 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 sews disposal system on the above captioned property.
Type of system: ❑ Conventional Other Ut'j-Z11 Septic Tank: ZQ d O gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches Z of each ditch / 7 S feet ditches feet ditches Z ! inches
French Drain Required: linear feet
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