OPHTE# 01 - :~--ZZS-aq Harnett County Department of Public Health 2 0 8 9 6
PERMIT # Z 5A 30 0 eration Permit
New Installation LI Septic Tank ❑ Repair Nitrification Line ❑ Expansion
PROPERTY LOCATION: /y37 zb
Name: (owner) .V~Llor4 /-/6~ p., arm, SUBDIVISION LOT # io
System Installer: - Registration #
Basement with plumbing: ❑ Garage / Number of Bedrooms
Type of Water Supply: ❑ Community L~J Public ❑ Well Distance from well feet
System Type: 2's'% PG=a)Owner ~zc Types V and VI Systems expire in 5 years.
(In accordance with Table must contact Health Department 6 months prior to expiration for permit renewal.
This system has been installed in ides for Sewage Treatment and Disposal, and all conditions of the Improvement Permit and Construction Authorization.
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PERMIT CONDITIONS:
1. 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 sew a disposal system on the above captioned property.
Type of system: ❑ Conventional Other ZS% JEy Septic Tank: I O O U gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of
Drainage field ditches y of each ditch 75' feet ditches 3 feet ditches 10" 7 I inchn<
French ram equire : Linear feet
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