OPHTE#07-s- J~S6 z Harnett County Department of Public Health 2 0 9 0 7
PERMIT # -316g(
[if Operation Peymiitt
New Installation 6 Septic Tank ❑ Repair Ld Nitrification Line ❑ Exnancinn
PROPERTY LOCATION: ~~103 ~►~c.~6~, _ ,~,p
Name: (owner) sT,tl,,c SUBDIVISION Fa~k~ LOT # Sd
System Installer. ~Registration #
Basement with plumbing: ❑ Garage C umber of Bedrooms-
Type of Water Supply: ❑ Community r Public ❑ Well Distance from well feet
System Type: ZS~' T 6--z- Types V and VI Systems expire in 5 years.
(In accordance with Table V a) MS Owner must contact Health Department 6 months prior to expiration for permit renewal.
>rxmn nay ueen mscaueo in compliance with applicable North Carolina General Statutes, Rules for Sewage Treatment and Disposal, and all conditions of the Improvement Permit and Construction Authorization,
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PERMIT CONDITIONS:
I. 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 sews disposal system on the above captioned property.
Type of system: ❑ Conventional 9 Other d64~, Septic Tank: loo o gallons Pump Tank: /oo y allons
Subsurface No. of exact length width of depth of g
Drainage Field ditches of each ditch feet ditches 3 feet ditches _Z q r (S3 inches
French Drain Required: Linear feet
Authorized State A Date 5 - I 0
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