OP RHTE#-CYc>--s-1yZg72 Harnett County Department of Public Health 21 0 3 4
PERMIT # Z57ZR Operation Pemit
New Installation I Septic Tank El Repair ililitrification Line ❑ Expansion
PROPERTY LOCATION:.~IY6-s'% ~ /-~'o
Name: (owner) SUBDIVISION _Lklc~ LOT # S` _
System Installer: Registration #
Basement with plumbing. ❑ Garage umber of Bedrooms
Type of Water Supply: El Community Public ❑ Well Distance from well feet
System Type: D Cl r' Zr G Types V and VI Systems expire in 5 years.
(In accordance with Table V a) wner must contact Health Department 6 months prior to expiration for permit renewal.
q,> . na ueen msraiwa in compliance with applicable North Carolina General Statutes, Rules for Sewage Treatment and Disposal, and all conditions of the Improvement Permit and Construction Authorization.
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PERMIT CONDITIONS:
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I. Performance:
II. Monitoring:
III. Maintenance:
IV. Operation:
V. Other.
System shall perform in accordance with Rule .1961.
As required by Rule .1961.
As required by Rule .1961. Other.
Subsurface system operator required? Yes ❑ No ❑
If yes, see attached sheet for additional operation conditions, maintenance and reporting
Following are the specifications for the sews disposal system on the above captioned property.
Type of system: ❑ Conventional Other zs~'o2 o c r~ ~r 6~1f2,. /ac,> Septic Tank: / oc--)o gallons Pump Tank: gallons
Subsurface No. Of exact length l; • width of depth of
Drainage field ditches y of each ditch 8o feet ditches 3 feet ditches-.LO *l " inches
French Drain Required: Linear feet
Authorized State A Date ~5~ 0 1 - I b
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