OP RHarnett County Department of Public Health 23216
PERMIT # ZZZZ Z Operation Pier it
1 NeW Installation Septic Tank Imo' Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION:,
Name: (owner) � `aim —•x-� SUBDIVISION LOT # l5—
System Installer: L&jeqfjeM %� 5 Registration #
Basement with plumbing: ❑ Garage 2"—Nu er of Bedrooms 3
Type of Water Supply: El Community C?°Public El Well Distance from well feet
h
System Type: z "` � +�'' r kZ l ;5 Types V and VI Systems expire in 5 years.
(In accordance with able V a) Ow r must contact Health Department 6 months prior to expiration for permit renewal.
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 ❑ No ❑
If yes, see attached sheet for additional operation conditions, maintenance and reporting.
IV. Operation:
V. Other:
❑
D -Box ❑
Pump ❑ Alarm
❑ H12OLine ❑ PWR Line
Following are the specifications for the sewage disposal ls stem on the above captioned property.
Type of system:
❑ Conventional ❑ Other
t'51;/- d✓ ' �--�
Septic Tank: gallons Pump Tank: /ClOe gallons
Subsurface
No. of
exact length
width of depth of
Drainage Field
ditches
of each ditch i v feet
ditches feet ditches 2A� IV inches
French Drain Required: Linear teet
Authorized State Age Date
i
14 -5 -32951 R (7)
14 -5 -32951 R (8)
14 -5 -32951 R (9)
14 -5 -32951 R (10)
14 -5 -32951 R (11)
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14- 5- 32951R (12)
14- 5- 32951R (13)
14- 5- 32951R (14)
14- 5- 32951R (15)
14- 5- 32951R (16)
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14 -5 -32951 R (17)
14 -5 -32951 R (18)
14 -5 -32951 R (19)
14 -5 -32951 R (20)
14 -5 -32951 R (1)