Loading...
OPHTE#_~,9-5 r Harnett County Department of Public Health 21 4 6 5 PERMIT #Operation Permit New Installation 'X Septic Tank ❑ Repair ~Z Nitrification Line ❑ Expansion PROPERTY LKATION: 95 Name: (owner) SUBDIVISION 13s,,tibo LOT # I System Installer. f~N,s MEpL1N Registration # Basement with plumbing: ❑ Garage X Number of Bedrooms 3 Type of Water Supply: ❑ Community Public ❑ Well Distance from well l©O 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. nn, stem nas oeen msraneo in compbance with applicable North Carolina General Statutes, Rules for Sewage Treatment and Disposal, and all conditions of the Improvement Permit and Construction Authorization. all)-~- pu t~ J S3' ~ SS~ Z DrDMIT rAIMITlnllf a.3 I~ be"3 co u r~[ 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: Subsurface system operator required? Yes ❑ No)< If yes, see attached sheet for additional operation conditions, maintenance ' and reporting. IV. Operation: V. Other. -l"o►Nty 1.~,,- C~~c-.c~~. Pv~,e 4P.LS~2r.. Ss ,LL `~S~o $S r G 4}~o e,C Following are the specifications for the sewage disposal system on the above captioned property. Type of system: ❑ Conventional X Other Q u mP 10 ~Z Ftio., , Septic Tank: L p©O gallons Pump Tank: ~ngO gallons Subsurface No, of exact length width of depth of Drainage Field ditches 3 of each ditch feet ditches 3 feet ditches inches French Drain Reouired: inati~(nnr Authorized State Agent ~l \S mC-Y. 6 Date 6 I q \v3 k n , i 14i o~,-~ -a33s5 1477 VA4 _F c 9~c4. l r . i< e i± c