OPHTE# Cq -'57- 3 ?s-6 e Harnett County Department of Public Health 23365
PERMIT # 218421 2Z New Perit
2 New Installation L?1 Septic Tank Z Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION: ffcJ /n)
Name: (owner) /%�, cRwt�� SUBDIVISION LOT #q
System Installer: J_s&,.. Registration #
Basement with plumbing: ❑ Garage �mber of Bedrooms 3
Type of Water Supply: ❑ Community Lit Public ❑ Well Distance from well feet
System Type: 25%. iZ Utz �_ *rs t-*; —T �,� ci C- Types V and VI Systems expire in 5 years.
(In accordance with Table V a) Owner must conta Department 6 months prior to expiration for permit renewal.
[his system has been Installed In compliance With applicable North larolina General )tatutes, iules for )ewage Ireatment and Ulsposal, and all conditions of the Improvement rermlt and lonstructlon Rutborizatlon.
PERMIT CONDITIONS:
I. Performance:
II. Monitoring:
III. Maintenance:
IV. Operation:
V. Other:
At--/( e9A-, -cJP__ GS�
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 sewage disposal system
on the above captioned property.
Type of system:
❑ Conventional [ ;'Other ZSib
Septic Tank: / 00 gallons Pump Tank: gallons
Subsurface
No. of
exact length
width of depth of
Drainage Field
ditches
of each ditch go feet
ditches 3 feet ditches inches
French Drain Required: Linear feet
Authorized State A nt Date 1 L
14 -5 -33500 (2)
14 -5 -33500 (3)
14 -5 -33500 (4)
14 -5 -33500 (5)
14 -5 -33500 (6)
14 -5 -33500 (7)
14 -5 -33500 (8)
14 -5 -33500 (12) 14 -5 -33500 (1)
14 -5 -33500 (9)
14 -5 -33500 (10)
14 -5 -33500 (11)