OP RHTE# I �_ 5 `3ss�3�Harnett County Department of Public Health 23608
PERMIT # 7a2cf(_®0t ep ration Permit �
0-"'N ew Installation Septic Tank D Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION;gt fGA-� /2'L�
Name: (owner) Z>A-L IE SUBDIVISION ,>A,IG> /lit v 2 LOT #
System Installer: . �� Q2:' f Tjb A-�� Registration #
Basement with plumbing: ❑ Garage ❑ umber of Bedrooms 3
Type of Water Supply: ❑ Community LJ' Public ❑ Well Distance from well feet
System Type: 25 °' f+%Su`< �L —. �+•t s fR— T,raa & 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 Treatment and Dispospl, and all conditions of the Improvement Permit and lonstruction Authorization.
1
10
0
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PERMIT CONDITIONS:
I. Performance:
II. Monitoring:
III. Maintenance:
IV. Operation:
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.
V. Other:
❑
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 Z Other
Septic Tank: gallons Pump Tank: gallons
Subsurface
No. of
exact length I_
t
width of depth of
3 y )1
Drainage Field
ditches 9
of each ditch 7`.a feet
P
ditches feet ditches inches
French Drain Required: Linear feet 7
Authorized State A Date ! �s
15-5-35553R (1)
15-5-35553R (2)
15-5-35553R (3)
15-5-35553R (4)
15-5-35553R (5)
15-5-35553R (6)
15-5-35553R (7)
15-5-35553R (11) 15-5-35553R (12)
15-5-35553R (8)
15-5-35553R (9)
15-5-35553R (10)