OPHTE#a~- Harnett County Department of Public Health 21 1 6 2
PERMIT # s. 0 eration Permit
New Installation Septic Tank ❑ Repair la"^Nitrification line ❑ Expansion
PROPERTY LOCATION: a2/
Name: (owner) h,J,L-3 11 SUBDIVISION .`l LOT # ~
System Installer: C1,r~c. ,r Registration #
Basement with plumbing: ❑ Garage 21~ umber of Bedrooms __2
Type of Water Supply: ❑ Community Z Public ❑ Well Distance from well feet
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.
nu> >rnem nee ueen nutauea in wmpuance wan applicable North larolina General Statutes, Rules for Sewage Treatment and Disposal, and all conditions of the Improvement Permit and Construction Authorization.
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PERMIT CONDITIONS:
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• .,JJ -11 3 au FVI IIn m dLLUIUAIIIC WILIJ RWe .17oi.
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 seewwajedisposal ,ystem on t e above captioned property.
Type of system: ❑ Conventional L+J Other Z Septic Tank: /Coo
gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches .3 of each ditch loo feet ditches feet ditches 24 inches
French Drain Required: _ Linear feet
Authorized State Agenttl~ Date /7 ~f