OP RHTE# Harnett County Department of Public Health 23210
PERMIT # 7-77'i Operation Per 't
I� New Installation Cc Tank Imo' Nitrification Line ❑ Repair ❑ Expansior
PROPERTY LOCATION:5 eil
Name: (owner) SUBDIVISION LOT #
System Installer: ,%Zb]y ' 6 7'�rz ,o Registration #
Basement with plumbing: ❑ Garage L2 Number of Bedrooms
Type of Water Sup;ly: ❑ Community 211ublic ❑ Well Distance from well feet
System Type: 1 4* -,�, Types V and VI S stems expire in 5 years.
(In accordance with able V a) Ow 6r must contact Health Departmen 6 months prior to expiration for permit renewal.
i� �
This system has been installed in compliance with applicable North Irolina General Statutes, Ruu�fo - rreaRyy
ment and Disposal, an all conditions of the Improvement Permit and Construction Authorization.
f
Y�
0
j
)
4
PERMIT CONDITIONS: _
I. Performance: System shall perform in accordance with Rule .1961.
II. Monitoring: As required by Rule .1961.
111. 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 ❑ H2OLine ❑ PWR Line
Following are the specifications for the seewwageAisposal system on the above captioned property.
Type of system: ❑ Conventional L�'`OtherZ5%v �& Ski Septic Tank: � gallons Pump Tank: ���'� gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches of each ditch 60 feet ditches feet ditches Zi7 7W 9 inches
French Drain Required: Linear feet
Authorized State Age Date
t
r
1
[-r
�l
i
�Y �
u
"`'" Y
\
a
14 -5 -33111 R (22)
14 -5 -33111 R (23)
14 -5 -33111 R (12)
14 -5 -33111 R (13)
14 -5 -33111 R (14)
14 -5 -33111 R (15) 14 -5 -33111 R (16)
1
[-r
�x
i
�Y �
� i � � °" 14
"`'" Y
\
14 -5 -33111 R (22)
14 -5 -33111 R (23)
14 -5 -33111 R (24)
14 -5 -33111 R (25)
14 -5 -33111 R (26)