OP RRHTE# .�34- Zn;/U Harnett County Department of Public Health 2334.9
PERMIT # ��� ?� 0 era p tion Per t
Id" New Installation Septic Tank Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LO(ATION;sXj4Q5_b_4&44 A6
Name: (owner) SUBDIVISION LOT # 5
System Installer: Registration #
Basement with plumbing: ❑ Garage umber of Bedrooms _„3_
Type of Water Supply: ❑ Community L'J Public ❑ Well Distance from well feet
System Type: 251'#1 t Cc, Cs?v -pes V and VI Systems expire in 5 years.
(In accordance with Table V a) Owner contact ea Department 6 mon h� prior to expiration for permit renewal.
This system has been installed in compliance with applicable North Carolina General
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and all cond' i s of the Improvement Permit and Construction Authorization.
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PERMIT CONDITIONS: r-)iW'
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 ❑ H2OLine ❑ PWR Line
Following are the specifications for the sew isposal system on the above captioned property.
Type of system: El Conventional Other `� rZktlwUtC Septic Tank: !, O y gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches of each ditch aO6 feet ditches feet ditches Je ' inches
French Drain Required: Linear feet
� S" 12 `►y
Authorized State Ag t /%* Date 7— 1.1
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14- 5- 33625RR (2)
14- 5- 33625RR (3)
14- 5- 33625RR (4)
14- 5- 33625RR (5)
14- 5- 33625RR (6)
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14 -5- 33625RR (7)
14- 5- 33625RR (8)
14- 5- 33625RR (9)
14 -5- 33625RR (10)
14 -5- 33625RR (11)