OPITE# Harnett County Department 23411
PERMIT # Operation Permit
New Installation X Septic Tank Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION: 1„y Gcz
Name: (owner) 'Ke �f. v L- t-)N P,..a SUBDIVISION LOT #
System Installer: -5iP,-.,�o V) >HC---,45 Registration #
Basement with plumbing: ❑ Garage Number of Bedrooms
Type of Water Supply: ❑ Community ;R� Public ❑ Well Distance from well 1(Z0 feet
System Type: == ell Types V and VI Systems expire in 5 years.
(In accordance with Table V a) Owner must contact Health Department 6 months prior to expiration for permit renewal.
This system has been installed in compliance with applicable North Carolina General Statutes, Rules for Sewage Treatment and Disposal, and all conditions of the Improvement Permit and construction Authorization
PERMIT CONDITIONS:
I. Performance:
11. Monitoring:
III. Maintenance:
IV. Operation:
V. Other:
r1t�
�1tEo
4�
C
i l7ToST— Q.D
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 cc
itions, maintenance and reporting.
❑ D -Box ❑ Pump ❑ Alarm ❑ H2O1-ine ❑
Following are the specifications for the sewage disposal system on the above captioned property.
Type of system: ❑ Conventional X Other CZ !o_oxc/ Septic Tank: 166C� gallons Pump Tank:
Sub No. of exact length width of depth of ig
Drainage Field es `� of each ditch aCi feet ditches feet ditches
French Drain Required: Linear feet
Authorized State Agent _ ____ �� ��� Q�y� Date 1 O
PWR Line
gallons
inches
i'-.) -S-3' �l �