OPHTE# I O~S 1A Harnett County Department of Public Health 21511
PERMIT # a~oas Operation Permit
New Installation Septic Tank ❑ RepairrX Nitrification Line ❑ Expansion
PROPERTY LOCATION: N 6-j."7 `,J
Name: (owner) Mar~u-o,~fl ~mES SUBDIVISION 'r`> >c, E ~p,,,,0A -LOT # t4 cl_
System Installer: -7'czp li,CL,,,.r r-,3 Registration #
Basement with plumbing: ❑ Garage 'U Number of Bedrooms 3
Type of Water Supply: ❑ Community IS~, Public ❑ Well Distance from well 1a C) 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.
Ines 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 ❑ NOX
If yes, see attached sheet for additional operation conditions, maintenance and reporting.
IV. Operation:
V. Other: S0PeL) L1r-,l~ Pv<., ~'LP2M S~.s> `Se gt: Lk
Following are the specifications for the sewage disposal system on the above captioned property.
Type of system: ❑ Conventional ~K Other PU~P~oC~as.r•,fb~~Qv,c~1~~ Septic Tank: 1000 gallons Pump Tank: tr306 allons
Subsurface No. of exact length width of g
Drainage Field ditches r~ 6 depth of
of each ditch feet ditches 3 feet ditches inches
French Drain Required: z
Authorized State Agent ~ 17 CikV_1 Date W~10