OP RFITE# .15 . -_ 3Z_30�4 Harnett County Department of Public Health 23219
PERMIT # eration Permit
New Installation Septic Tank LEI' Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION:'I . Z ,H '4
Name: (owner) I SUBDIVISION LOT # C
System Installer: _' ;7 /.IoV re S Registration #
Basement with plumbing: ❑ Garage 2'-Number of Bedrooms
Type of Water Supply: ❑ Community 2" Public ❑ Well Distance from well feet
System Type: 1? — es V and VI Systems expire in 5 years.
(In accordance with Table V a) wner must contact a 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 Authorization
PERMIT CONDITIONS:
I. Performance:
II. Monitoring:
III. Maintenance:
IV. Operation:
V. Other:
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.
❑ D -Box ❑ Pump ❑ Alarm ❑ H2OLine ❑ PWR Line
Following are the specifications for the sewaa disposal system on the above captioned property.
Type of system: ❑ Conventional L?f Other 1-5✓ VDU L'ty, Septic Tank: gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches of each ditch feet ditches feet ditches Zy inches
French Drain Required: Linear feet
Authorized State Age 'c Date �%
13- 5- 32309R (2)
13- 5- 32309R (3)
13- 5- 32309R (4)
13- 5- 32309R (5) 13- 5- 32309R (6)
13- 5- 32309R (7)
13- 5- 32309R (8)
13- 5- 32309R (9)
13- 5- 32309R (1)