OP R-CAN NOT SIGN OFF IN HTE PER DONNA PERMITS NOT PURCHASED.HTE# t4 -,<- 3Z-74,Z4 Harnett County Department of Public Health 2
PERMIT # a-7? Z0 Operation Plermit
2 New Installation 0 Septic Tank Vitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION:rnt'Y�ta
Name: (owner) SUBDIVISION LOT #
System Installer: Registration #
Basement with plumbing: ❑ Garage ❑ Number of Bedrooms 5
Type of Water Supply: ❑ Community C"Public ❑ Well Distance from well 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.
This system has been installed in compliance with applicable North tarolma General )tatutes, Nules lot Newage treatment and Uisposal, and all conditions of the Improvement rermt[ and lonstructmn Autnoraanon.
Q—
&V i `7-0
PERMIT CONDITIONS:
I. Performance:
11. 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.
❑ D -Box ❑ Pump ❑
Following are the spec) ations for the sewage disposal system on the above captioned property.
Type of system: Conventional ❑ Other
Subsurface No. of exact length
Drainage Field ditches of each ditch feet
Alarm ❑
F120Line ❑
PWR Line
Septic Tank: gallons Pump Tank: gallons
width of depth of
ditches 3 feet ditches 01 inches
French Drain Required: Linear feet
Authorized State A Date " 11 -14
14- 5- 32762R (2) 14- 5- 32762R (3) 14- 5- 32762R (4) 14- 5- 32762R (5) 14- 5- 32762R (6)
14- 5- 32762R (7) 14- 5- 32762R (1)