OPHTE# 19— 5`'3Sb-'70 Harnett County Department of Public Health 23595
PERMIT # Z 13 Z45�O�peration Per It
2 New Installation Septic Tank itrlfication Line ❑ Repair ❑ Expansion
PROPERTY LOCATION: 75x_lg3'7-
Name: (owner)S7ZL?J�i/ -s SUBDIVISION AL,,-p�e !av ' LOT .5
System Installer: Registration #
Basement with plumbing: ❑ Garageumber of Bedrooms . 5)®
Type of Water Supply: ❑Community L Public ❑ Well stagy frim well feet
System Type: ZS01,b _6 V and VI Systems expire in 5 years.
(In accordance with Table V a) Owner must contact He9t Department 6 months prior to expiration for permit renewal.
This system has been installed in Xmpliance with applicable North Carolina General Statutes, Rules for Sewage Treatment
PERMIT CONDITIONS:
I. Performance:
If. Monitoring:
III. Maintenance:
IV. Operation:
V. Other:
a
and all conditions of the Improvement Permit and Construction Authorization.
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 conditions, maintenance and reporting.
❑ D -Box ❑ Pump ❑ Alarm ❑ H2OLine ❑ PWR Line
Following are the specifications for the sews a disposal system on the above captioned property.
Type of system: ❑ Conventional W Other Z�/bf2-rpoC1747�,) Septic Tank: °o gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches of each ditch 60 feet ditches feet ditches inches
French Drain Required: Linear feet
Authorized State A n+ � -� I ia--�_ �~'� Date 5 —*2 2 t S
14-5-35070 (1) 14-5-35070 (2) 14-5-35070 (3) 14-5-35070 (4) 14-5-35070 (5)
14-5-35070 (6) 14-5-35070 (7)