OPHTE# tj -5 -53'�2-1
Harnett County
Department of
Public Health
23343
PERMIT # Z'1,
/ Operation Per It
Q New Installation Septic Tank Z Nitrification Line
❑ Repair ❑ Expansion
PROPERTY LOCATION: rte- 'S-� lyg � e-!v A6
Name: (owner) I o>v, �,-y i SUBDIVISION LOT # E
System Installer: « Registration #
Basement with plumbing: ❑ Garage ❑ Number of Bedrooms 3
Type of Water Supply: ❑ Community 12' Public ❑ Well Distance from well feet
System Type: Z5 %r1.Q4Wtrc-A1 t _ sL! ypes V and VI Systems expire in 5 years.
(In accordance with Table V a) 0 �forsSte nta Health Department 6 months prior to expiration for permit renewal.
This system has been installed in compliance with applicable Nort �General es, a Treatment and Disposal, and all conditions of the Improvement Permit and Construction Authorization.
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PERMIT CONDITIONS:
I. Performance:
11. Monitoring:
III. Maintenance:
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in acc ue with Rule .I
G
A e�gtfrrtif by Rule .1961. Other:
Sub urface system operator required? s ❑ No ❑
If ye see attached sheet for add' 'onal 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 above captioned property.
Type of system: ❑
Conventional
Other ZS ` ilSB u Septic Tank: 0
gallons Pump Tank: gallons
Subsurface
No. of
exact length width of
depth of
Drainage Field
ditches
of each ditch �' feet ditches
feet ditches Ly inches
French Drain Required: Linear feet
Authorized State Ag �� Date 9--3 —/y
14 -5 -33921 (2)
14 -5- 33921(3)
14 -5 -33921 (4)
14 -5 -33921 (5)
14 -5 -33921 (6)
14 -5 -33921 (7)
14 -5 -33921 (1)
14 -5 -33921 (6)
14 -5 -33921 (9)
14 -5 -33921 (10)
14- 5- 33921(11)