OPHTE#IDl-6-z3Z22 Harnett County Department of Public Health 21 0 3 3
PERMIT # ZS7 / Operation P mit
d New Installation Septic Tank ❑ Repair /Nitrification Line ❑ Expansion
PROPERTY LOCATION:.S i21 Li b 3 CO, ~
Name: (owner) SUBDIVISION _z s LOT
System Installer: T Registration #
Basement with plumbing: Garage! umber of Bedrooms
Type of Water Supply: ❑ Community Ll Public ❑ Well Distance from well feet
System Type: EZ o -r 0,11, ZU- G- 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.
This system has been installed in
North Carolina General Statutes, Rules for Sewage Treatment
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PERMIT CONDITIONS:
P
or
LP) 1.
I. 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 ❑ No ❑
If yes, see attached sheet for additional operation conditions, maintenance and reporting.
IV. Operation:
V. Other
all conditions of the Improvement Permit and Construction Authorization.
40 sqaA;E~
Following are the specifications for the sews disposal system on the above captioned property.
Type of system: ❑ Conventional EOther `'~t,~?rr~t1GTZ03a 2 J Septic Tank / be r7 gallons Pump Tank: gallons
Subsurface No. of exact length o width of depth of
Drainage Field ditches -3 of each ditch 4 D feet ditches 3 feet ditchesO ` o inches
French Drain Required: Linear feet
Authorized State A n~ 'f
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