OPHarnett County Department of Public Health 23214
PERMIT # 2b 0 ep ration Per 6t
L New Installation Septic Tank Vitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION:
Name: (owner) �) r,2 w SUBDIVISION LOT # Zsk
System Installer: dh "r, Registration #
Basement with plumbing: ❑ Garage ❑ Number of Bedrooms
Type of Water Supply: El Community 1:1 Public Z Well Distance from well ' �` feet
System Type:` Types V and VI Systems expire in 5 years.
(In accordance with Table V a) Owner must font ft 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
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CE
PERMIT CONDITIONS:
I. Performance:
11. Monitoring:
III. Maintenance:
IV. Operation:
V. Other:
am
and Disposal, and all conditions of the
R
v
a
AA
XV
System shall perform in accordance with Rule .1961.
As required by Rule .1961.
As required by Rule .1961. Other:
Subsurface system operator required? Yes ❑ No ❑
If yes, see attached sheet for additional operation conditions, maintenance and reporting.
Permit and Construction Authorization.
ye'
❑
D -Box ❑
Pump ❑ Alarm
❑ H2OLine ❑ PWR Line
Following are the specifications for the sewage disposal system on the above captioned prope
Type of system:
❑ Conventional C Other ZQ
ti . '
Septic Tank: gallons Pump Tank: gallons
Subsurface
No. of
5
exact length
width of depth of
2- inches
Drainage Field
ditches
of each ditch t ®b feet
ditches feet ditches
French Drain Required: Linear feet
Authorized State Age Date
l
14 -5 -33463 (2)
14 -5 -33463 (3)
14 -5 -33463 (4)
14 -5 -33463 (5)
14 -5 -33463 (6)
14 -5 -33463 (7)
14 -5 -33463 (8)
14 -5 -33463 (9)
14 -5 -33463 (10)
14 -5- 33463(12)
14 -5 -33463 (13)
14 -5 -33463 (14)
14 -5 -33463 (1)
14 -5 -33463 (11)