OPHTE # ►Lj-5—'3'f90 Harnett County Department of Public Health 23642
PERMIT # �` �) Operation Permit
New Installation Septic Tank Nitrification line ❑ Repair ❑ Expansion
PROPERTY LOCATION: Pr�pt�ac� �r3
Name: (owner) c- SUBDIVISION 1 LOT # 51
System Installer: Registration #
Basement with plumbing: ❑ Garage Number of Bedrooms—3
Type of Water Supply: ❑ Community Public ❑ Well Distance from well 100 feet
System Type: 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 Trp"os-and Disposal, and all conditions of the Improvement Permit and Construction Authorization
YtKMIl LUNUIIIUNJ:
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 ❑ Ny
If yes, see attached sheet for additional operation conditions, maintenance and reporting.
IV. Operation:
V. Other:
❑ D -Box ❑ Pump ❑
Following are the specifications for the sewage disposal s stem on above captioned property.
Type of system: El Conventional ;IA Other �O 4✓
Subsurface No. of exact length
Drainage Field ditches of each ditch Y'9® feet
French Drain Required: Linear feet
Alarm ❑
H2O1 ine ❑
PWR Line
Septic Tank: 6 ®6 G gallons Pump Tank: gallons
width of depth of
ditches feet ditches c3�. inches
Authorized State Agent Date 51)S -I)5"
k L -i - 5 - 0�