OPHTE# \' 5 -a�o Harnett County Department of Public Health 23168
PERMIT # `2—"i 1`b Operation Permit
New Installation . Septic Tank Nitrification Line 1:1 Repair 1:1 Expansion
PROPERTY LOCATION: Y Xn G
Name: (owner) Jpv.f-yaMrcS SUBDIVISION sv1 -P,e� �•2s�cj LOT #
System Installer: "efuvi%A Registration #
Basement with plumbing: ❑ Garage Number of Bedrooms L
Type of Water Supply: ❑ Communi Public ❑ Well Distance from well LUQ feet
System Type: D 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 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:
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:
❑ D -Box ❑ Pump ❑ Alarm ❑ H2OLine ❑ PWR Line
Following are the specifications for the sewage cisposaj �1 ystem on the above captioned property.
Type of system: El Conventional Other (( U m , b 2 —22 11(!,,, Septic Tank: 10 ® O gallons Pump Tank: 1000 gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches of each ditch t'?C) feet ditches 3 feet ditches N -_34 inches
French Drain Required: _ _ — Linear feet
Authorized State Agent iz&�A 5 Date