OPHTE# r3-- 5=3'39 Harnett County Department of Public Health 23123
PERMIT # �-� Operation Permit
New Installation -*t� Septic Tank Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION: Mcf.X.5
Name: (owner) Cup,(be z to+HU 1�a c�CS 1NG SUBDIVISION �N Wps-o LOT # VZl,
System Installer: —moo rJ Registration #
Basement with plumbing: ❑ Garage)< Number of Bedrooms >
Type of Water Supply: ❑ Community 'X Public ❑ Well Distance from well i 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.
Ims system has been installed in compliance with applicable North larolma beneral )tatutes, Rules for )ewage Ireatment and
65'
j -6G�
and all conditions of the Improvement Permit and Construction Authorization.
L- 0C;<w0UR p2
PERMIT CUNDITIUNS:
I. Performance: System shall perform in accordance with Rule .1961.
ll. Monitoring: As required by Rule .1961.
III. Maintenance: As required by Rule .1961. Other:
Subsurface system operator required? Yes ❑ N
If yes, see attached sheet for additional operation conditions, maintenance and reporting.
IV. Operation:
V. Other:
❑ D -Box ❑
Following are the specifications for the
Type of system: ❑ Conventional
Subsurface No. of
Drainage Field dltc eTi V
French Drain ReciuiredC-,-.
Pump ❑ Alarm ❑ H2O1-ine ❑
sewage disposal system o the above captioned pr perty.
Other 9 1) � O >lP+mQN./ Septic Tank: 1000 gallons Pump Tank: 1 d�
exact length width of ,3 depth of
of each ditch 1 �.� feet ditches feet ditches a )i '3A
Authorized State Agent ��, ������ Date 1461 D
PWR Line
gallons
inches
V�- 5'. 3 N34