OPz•- • Harnett County Department
PERMIT # �^%�11� Operation Permit
New Installation Septic Tankl Nitrification Line ❑ Repair El Expansion
PROPERTY LO(ATIO : C.iz)rf LOQ)P
Name: (owner) SUBDIVISION \vlC,sN i_;\wCnrAC Q \� �JL ?roc �� LOT # IGO
System Installer: &c)p - G Registration #
Basement with plumbing: ❑ Garage k Number of Bedrooms
Type of Water Supply: ❑ Community 4�i Public ❑ Well Distance from well C b® 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.
mis system nas peen instanea in compuance wem appncaove norm carouna uenerai xamtes, nmes for sewage ireatment ano
M
ana an conamons of me improvement rermir ana conscrucuon Minonzanon.
PERMIT CONDITIONS:
1. Performance: System shall perform in accordance with Rule .1961.
11. 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:
❑ D -Box ❑ Pump ❑ Alarm ❑ H2OLine ❑ PWR Line
Following are the specifications for the sewage disposal °system on the abovg captione4 property.
Type of system: Conventional
El t, ;>,MrJ Septic Tank: V2. O gallons Pump Tank: gallons
Subsurface of exact length width of depth of
Drainage Field ditches of each ditch a0c5 feet ditches feet ditches 30 inches
French Drain Reauired:,, . ear
Authorized State Agent Date 5141 l—)
►�- 5.3300