OPHTE# tit :5.:-3 If 7 /Z. Harnett County Department of Public Health 23581
PERMIT # ZSad Operation Permit
LTJ" New Installation Z Septic Tank Z Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION:-=y�vvs p,-b
Name: (owner) ZoAe SUBDIVISION LOT #
System Installer:Registration #
Basement with plumbing: ❑ 0r Garage ❑❑ )1mber of Bedrooms
Type of Water Supply: ❑ Community Er Public ❑ Well Distance from well feet
System Type: 25Yc> f?F. c L E Types V and VI Systems expire in 5 years.
(In accordance with Table V a) Owner must conta Health Department 6 months prior to expiration for permit renewal.
This system has been installed in compliance with applical le North Carolina General Statutes, Rules for Sewage Treatment and Disposal, and all conditions of the
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PERMIT CONDITIONS:
I. Performance: System shall perform in accordance with Rule .1961.
II. 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:
Permit and Construction Authorization.
❑ D -Box ❑ Pump ❑ Alarm ❑ H2OLine ❑ PWR Line
Following are the specifications for the sewau disposal system on the above captioned property.
Type of system: ❑ Conventional YOther5'�FI/P1�1 ! Septic Tank: / 7- a gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches 3 of each ditch c' D feet ditches – feet ditches .2 inches
French Drain Required: Linear feet
Authorized State Ag6t Date t;7— 7 —IS
14-5-34712 (1)
14-5-34712 (2)
14-5-34712 (3)
14-5-34712 (4)
14-5-34712 (5)
14-5-34712 (6)
14-5-34712 (7)
14-5-34712 (8)
14-5-34712 (9)
14-5-34712 (11)
14-5-34712 (12)
14-5-34712 (13)
14-5-34712 (14)
14-5-34712 (10)