OP RHTE# f3� Harnett County Department of Public Health
PERMIT # Operation Per nit 22689
2'--New Installation ki Septic Tank Z,' Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION: ci6 k cH 2,
Name: (owner) SUBDIVISION � r t; T-s LOT # �
System Installer: Registration #
Basement with plumbing: ❑ Garage umber of Bedrooms
Type of Water Supply: El IJ Community Public I ❑ Well Distance from well feet
System Type: ` 1 ` � Types and VI Systems expire in 5 years.
(In accordance with Table V a) Owner must c tact Health D artment 6 months prior to expiration for permit renewal.
This system has been installed in compliance with applicable Noro Cara General Statutes, Rules for Sewage Treatment and Dispkal, and all conditions of the Improvement Permit and Construction Authorization
PERMIT CONDITIONS:
I. Performance: System shall perform in accordance with Rule .1961.
11. Monitoring: As required by Rule .1961.
Ill. 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:
❑ D -Box ❑ Pump ❑ Alarm ❑ H2OLine ❑ PWR Line
Following are the specifications for the sews a disposal system on the above captioned property.
Type of system: ❑ Conventional Z Other Z'�;b c� Septic Tank: 1 1D gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches of each ditch 160 feet ditches feet ditches inches
French Drain Required: Linear feet
Authorized State Age
2 'r Date
13- 5- 31096R (1)
13- 5- 31096R (2)
13- 5- 31096R (3)
13- 5- 31096R (4)
13- 5- 31096R (5)
13- 5- 31096R (6)
13- 5- 31096R (7)
13- 5- 31096R (8)
13- 5- 31096R (9)
13- 5- 31096R (10)
13- 5- 31096R (1)
13- 5- 31096R (2)
13- 5- 31096R (3)
13- 5- 31096R (4)
13- 5- 31096R (5)
13- 5- 31096R (6)
13- 5- 31096R (7)
13- 5- 31096R (8)
13- 5- 31096R (9)
13- 5- 31096R (10)