OP - Can not sign off in HTE per J Brock have not purchased permits yetHTE# /q—n�39,�2-7 Harnett County Department
PERMIT # Z`&c,t. 3 Operation Permit
9 New Installation Tank nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION:-�r-1-sa7a
Name: (owner) /6/ SUBDIVISION LOT #
System Installer: Registration #
Basement with plumbing: ❑ Garage ��umber of Bedrooms Z
Type of Water Supply: ❑ Community L7 Public ❑ Well Distance from well feet
System Type: 0 /3 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.
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 ❑
Following are the ssppec.. ations for the sewage disposal system on the above captioned property.
Type of system: Lff Conventional ❑ Other
Subsurface No. of exact length
Drainage Field ditches 3 of each ditch f `, feet
French Drain Required: Linear feet
Alarm ❑
H2O1-ine ❑
PWR Line
Septic Tank: I o 6 o gallons Pump Tank: gallons
width of depth of
ditches feet ditches 2q inches
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