OP RHTE# ,z s- zs��r� Harnett County Department of Public Health 23473
PERMIT # Z7681 eration Permit
New Installation Septic Tank 2 Nitrification Line ❑ Repair ❑ Expansior
PROPERTY LOCATION: r�
Name: (owner) SUBDIVISION '�,1���c LOT # y71-W
System Installer: S a f vcz .� Registration #
Basement with plumbing: ❑ Garage ❑ Number of Bedrooms .3
Type of Water Supply: ❑ Community ❑ Public ❑ Well Distance from well feet
System Type: "o i111�uG*r,oy�, s �G- 2 i —/ Types V and VI Systems expire in 5 years.
�In accordance with Ta e V a) Owner must contact Health Department 6 months prior to expiration for permit renewal.
This system has been installed i compliance with applicable North Carolina General Statutes, Rules f e reatment and Disposal, and all conditions of the Improvement Permit and Construction Authorization.
PERMIT CONDITIONS:
I. Performance:
11. Monitoring:
III. Maintenance:
IV. Operation:
V. Other:
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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 ❑ 142O1-ine ❑ PWR Line
Following are the specifications for the seewwaS/� disposal system on the above captioned property.
Type of system: ❑ Conventional Ld" Other ZsV1,, IW-by 3 Septic Tank: /000 gallons Pump Tank: ! v ° O gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches Z of each ditch Z, c) feet ditches feet ditches inches
French Drain Required: Linear feet
Authorized State Ag G `" `,a- _= �' Date /a
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12- 5- 29699R (7) 12- 5- 29699R (8)
12- 5- 29699R (9)
12- 5- 29699R
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12- 5- 29699R (11)
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