OPHTE# 13 -5- 31317 Harnett County Department of Public Health
PERMIT # e?-7s -o8 Operation Permit 22949
Er New Installation 2"'Septic Tank El'— Nitrification line ❑ Repair ❑ Expansion
�/ PROPERTY LOCATION: t0Q,.fJ2-
Name: (owner) �'l `�ie� lfio.�e1 SUBDIVISION LOT # vU
System Installer: C' ')d Registration #
Basement with plumbing: ❑ Garage ❑ Number of Bedrooms
Type of Water Supply: ❑ Community 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.
Ihls system has been Installed In compliance with applicable North l.arolma beneral Statutes, Rules for Sewage Treatment and Disposal, and all conditions of the Improvement Permit and Construction Authorization.
4-fo -,ck r cA 8128113
DGDMIT rr1A1111TIMIC•
by
I. Performance: System shall perform in accordance with Rule .1961.
11. Monitoring: As required by Rule .1961.
III. Maintenance: As required by Rule .1961. Other:
Subsurface system operator required? Yes ❑ No 0'
If yes, see attached sheet for additional operation conditions, maintenance and reporting.
IV. Operation:
V. Other:
❑ D -Box ❑ Pump ❑ Alorm ❑ H20Line ❑ PWR Line
Following are the specifications for the seewwardispcf system on the above capti ed property.
Type of system: ❑ Conventional Ld Other. vL �r i> %e,f c�n�be- Septic Tank: /000 gallons Pump Tank: 1000 gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches -�-- Jam — of each ditch feet ditches feet ditches /o "oZ8 inches
French Drain Required: \ ° . ® tiKN'feet
Authorized State Agent `+''1N1`a`a'V Date
- s =31,717