OPH T E # U"1-5, ~9 Harnett County Department of Public Health 2 0 8 7 0
PERMIT # 5 (,y3 Operation Permit
I;, New Installation Septic Tank ❑ Repair; Nitrification Line ❑ Expansion
PROPERTY LOCATION: v,KN LS _Q-ECv,Ro
Name: (owner) SmF-Lv~ Q_ fir, Ac--) SUBDIVISION LOT #
System Installer. Registration # 1
Basement with plumbing: ❑ Garage ❑ Number of Bedrooms BLa I OR (N0C""~
Type of Water Supply: ❑ Community ❑ Public `K Well Distance from well to d feet;
System Type: sZh Types V and VI Systems expire in S years.
(In accordance with Table V a) Owner must contact Health Department 6 months prior to expiration for permit renewal.
ims system has 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.
I
1
2l5
S; qn, N
C~Q
~,.,>tJE~ 5,-ta'
(~Ct,l J E W EL1-.
I
DrDMIT rntl NTin11C.
1. Performance: System shall perform in accordance with Rule .1961.
II. Monitoring. As required by Rule .1961.
111. Maintenance: As required by Rule .1961. Other.
Subsurface system operator required? Yes ❑ NoX
If yes, see attached sheet for additional operation conditions, maintenance and reporting.
IV. Operation:
V. Other:
Following are the specifications for the sewage disposal system on the above captioned property.
Type of system: 'X Conventional ❑ Other Septic Tank: loop gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches V of each ditch S d feet ditches 3 feet ditches inches
French Drain Required: ham, art
Authorized State Agent ~ Y-, ~EytS Date y
s
Alt
ff
4 ~~fr~ ~ ^a r
~a
~
r ~
st Z
l
c
1, °'l~F. 1,
-
-<r ,.li~%~~IS
3.
MIZ
i '
as
• 4
3iv+F
f+ ~
f
E., ~lq
~Fk
.y
n_ r
~
?
,a} 4
F T~ 4
~ "SZ 1 S
s .
~ 7~ r -
i
a.
y
0°1-
4 [ n y rFl~
i z
rt~ ~ ~ a. ~.p fir.
~$1r i.. ~ 7 f
Vf
e
Y
N
x
3
-
I
1
ke,
a.
' x
W y.c~
41
y
z~ ~r
AV
tA
Y
,
i
f t ~ ~ t ✓ fix t
r~ r t
- ~l n,!t
i-
k
~iYf a1r 3l S,~n y~l A ,
lµ~~ X^
- Z otra
N»
lx~
oc,- s-aa6q~