OPHTE# OS-- 5 - L2a73 Harnett County Department of Public Health 2 0 8 9 8
PERMIT # 25Y67 Operation Pepit
Y New Installation Septic Tank (Repair Nitrification Line ❑ Expansion
PROPERTY LOCATIM54I7Of z&2j;5,n
Name: (owner) SUBDIVISION ,1ciL~~ LOT # C~
System Installer: Registration #
Basement with plumbing: ❑ Garage ❑ Number of Bedrooms 3
Type of Water Supply: ❑ Community 2 Public ❑ Well Distance from well feet
System Type: Tam 7ir -~/h~,a*es 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.
This system has been installed in compliance with applicable orth Carolina General Statutes, Rues a Treatment and Disposal, and all conditions of the Improvement Permit and Construction Authorization.
d ~ b cr,~ ~S
-k z~sM14~6 R5 pc pd
Tt,
<SNwlkw cwt Ull.vii S4►Sroa1 t Z
dr Q-4 frrL J
G„ Ar --Z)
s3
O 1 .JZ
ppftC 04 _
5
3 P/c,
t
1~ V
V
PERMIT CONDITIONS:
1. Performance: System shall perform in accordance with Rule .1961.
11. 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 sewafxldisposal system on the above captioned property.
Type of system: ❑ Conventional Q" Other Z:24 keh-b c ri Septic Tank: O O 0 gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches 3 of each ditch feet ditches feet ditches -.V -J16 inches
French Drain Required: Linear feet r
[Authorized State Age Date 1x-18 -d
T
k
_n +c
Off,
3Sn
6
S`
1
F
W
s
'
`
~
i
~
•
• ~ ~
, «
rk ~