OPHTE #I %`� -� - 71, -71, z Harnett County Department of Public Health 23483
PERMIT # 2 609 1 Operation Permit 1-
C�rNew Installation O'� Septic Tank Z' Nitrification Line ❑ Repair ❑ Expansior
Name: (owner) --j `" ,e
System Installer:
Basement with plumbing: ❑ Garage um Eb
Type of Water Supply: ❑ Community I" Public
System Type: -2ff-76YLJ&6 -v-c �
(In accordance with Table V a)
PROPERTY LOCATION -�V17,s,' gI6
r
SUBDIVISION E,;- , LOT # ZI
Registration #
r of Bedrooms t
❑ Well Distance from well feet
Types V and VI Systems expire in 5 years.
Owner jnust contact Health Department 6 months prior to expiration for permit renewal.
This system has been installed in compliance with applicable North CaroliT-Gener44tatutes; - Rules - (Dr- Sewage Treatment and - Disposal, and- all--conditions of the Improvement Permit and Construction Authorization
a9 t`y
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7" via,
76' a_ --
2a ' TwI Ali >I
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PERMIT CONDITIONS:
I. Performance: System shall perform in accordance with Rule .1961.
11. 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 ❑ H2O1-ine ❑ PWR Line
Following are the specifications for the sewage disposal system on the above captioned property.
Type of system: ❑ Conventional Ca' Other VtXZ,� Septic Tank: f 2Oc) gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches of each ditch feet ditches ..3 feet ditches 2 ®�J inches
French Drain Reauired: Linear feet
Authorized State Aye t _--- -f "�"- i �r � '"? Date /f —
14 -5 -34762 (3)
14 -5 -34762 (4) 14 -5 -34762 (5) 14 -5 -34762 (6)
14 -5 -34762 (7) 14 -5 -34762 (8) 14 -5 -34762 (1)
14 -5 -34762 (2) 14 -5 -34762 (3) 14 -5 -34762 (4) 14 -5 -34762 (5) 14 -5 -34762 (6)
14 -5 -34762 (7) 14 -5 -34762 (8) 14 -5 -34762 (1)