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OPHTE#~~-s- Harnett County Department of Public Health 21031 PERMIT # ZS81( ~ / Operatl0nn _PQIt © New Installation 13 Septic Tank ❑ Re air PROPERTY LOCATION:, z 7 p 2/"Nitrification line 11 Expansion Name: (owner) /~r~ SUBDIVISION System Installer: ~w 4- LOT # Basement with plumbing: ❑ Garage ❑ Number of Bedrooms 3 Registration # Type of Water Supply: ❑ Community 2' Public ❑ Well Distance from well System Type: 4a- F-7 1SF-7 feet Sy accordance with Table V a) Types V and VI Systems expire in 5 years. (In 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, s for Sewage Treatment and DiAposal, and all conditions of the Improvement Permit and construction Authorization. ~`p7f}y~ 6sp y-.LJ ' ~ Dta t~ ~ h V t fa r PERMIT CONDITIONS: - - I. Performance: System shall perform in accordance with Rule .1961. Z 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. Following are the specifications for the sew 8e disposal system on the above captioned property. Type of system: ❑ conventional !11 Other ~o c" Subsurface No. of Septic Tank: Icon gallons Pump tank: allons exact length width of g Drainage field ditches of each ditch depth of French Drain Required: feet ditches 3 _ feet ditches Zy inches Linear feet j Authorized State A e omk Date -7 I 2'e F_ i, G 'F Y t ~s A Nom... S. -}r 17.~ r f~ < I, iALI If, -A f.~ , 1. t ,4 fr 4 r .1 Y y S mom A t' f, I tx 3 S G ~A e ,,yycc~~ i s-. int r g i I14:µ ~ Y s D.'i ~Z" t r.. Mae ff } ~ r