OPHTE #` -3io Harnett County Department of Public Health
PERMIT # 7. -7'3'7y_ Operation Permit 22981
12 NeW Installation 2 Septic Tank LAS Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION: wit tys7 ,c°,W pu'a
Name: (owner) Zee. SUBDIVISION WI LOT # /a)
System Installer: 71— dfz -zap Registration #
Basement with plumbing: ❑ Garage 2" mber of Bedrooms 3
Type of Water Supply: ❑ Community Public ❑ Well Distance from well feet
System Type: u 4 2s"° ,) % r- Z B Types V and VI Systems expire in 5 years.
(In accordance with Ta le V a) �Owne must contact Health Department 6 months prior to expiration for permit renewal.
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: d
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 disposal system on the above captioned prop ,..
Type of system:
El L_f Other Z9/6 A -f)Jti 1A) S 5 >r.. Septic Tank: gallons Pump Tank: t $ ' gallons
Subsurface No. of exact length I width of depth of
Drainage Field ditches of each ditch A1,0 feet ditches feet ditches i �o- inches
French Drain Required: Linear feet
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