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OP RHTE#o°1--s- Harnett County Department of Public Health 21 2 3 8 PERMIT # Operation Permit N New Installation Septic Tank ❑ RepairX Nitrification Line ❑ Expansion PROPERTY LOCATION: t!IC.a.1 Name: (owner) Curr,6EQ.LD,XJ VncnL,5 SUBDIVISION M,ac LOT # System Installer: 1 En ~jj ad~cN Registration # Basement with plumbing: ❑ Garage X Number of Bedrooms 3 Type of Water Supply: ❑ Community Public ❑ Well Distance from well I, 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. ims system nas been installed in compliance with applicable North Carolina General Statutes, Rules for Sewage Treatment and Disposal, and all conditions of the Improvement Permit and Construction Authorization. ( P O rne 'T'o ' G C' N'4 & Js rotvps 2-EpA S (Z' f 5~"ny9' ly Sod, p o.re~, !ti IZ ~ R Ir wlA ~i SUnle,0r- 021J~ Dro MIT rA11n IT1Allf. 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 sewage disposal system on the above capti ed property. Type of system: ❑ Conventional XI Other C.~ cse,eF~ LQ- 1 c t Lt~ Septic Tank: ~ O © O gallons Pump Tank: gallons Subsurface No. of exact length width of depth of Drainage Field ditches of each ditch t O feet ditches feet ditches inches French Drain Reouired:--- ~~lina+:r Authorized State Agent. Date T 111 Olt- Al, C R' N-i x ~ - x Oy -S ~ ~'~,53a2 -41 t .r , 4k4' ~t i t ~ £ . •,"~kcd~ 1 Vh,