OPHTE# P9 Z~z Dy Harnett County Department of Public Health 21 0 3 8
PERMIT # Z5"7ol 0 eration -P~miitt
5 New Installation L~1 Septic Tank 0 Repair Ed N itrifcatio
PROPERTY LOCATION:_ f f-s n line f Expansion
Name: (owner) _ SUBDIVISION - C-ow
System Installer. bTr r.72 ~2 LOT #
Registration #
Basement with plumbing: ❑ Garage ❑ Number of Bedrooms a&ld, srx,.rp_
Type of Water Supply: ❑ Community Public ❑ Well Distance from well
System Type: r_'a,.ar-,,_ a feet
(In accordance with Table V a) Types V and VI Systems expire in 5 years.
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 Authorrzation.
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PERMIT CONDITIONS:
I. Performance: System shall perform in accordance with Rule .1961. /mil 5-5--
If. Monitoring: As required by Rule .1961.
III. Maintenance: As required by Rule .1961. Other.
Subsurface system operator required? Yes ❑ No ❑
IV. Operation: If yes, see attached sheet for additional operation conditions, maintenance and reporting.
V. Other.
Following are the sp ififications for the sewage disposal system on the above captioned property.
Type of system: LJ Conventional ❑ Other
Subsurface No, of exact length Septic Tank: OOO gallons Pump Tank: gallons
Drainage field ditches 2-
of each ditch width of depth of French Drain Required: feet ditches 3 feet ditches 21f
Linear feet 1g inches
Authorized State Ager~tl- ~ _ L1 ~
` ' Date 7 16 2~Gf