OPHTE Harnett (ounty Department
PERMIT # `��� Operation Permit
New Installation 1K Septic Tank X Nitrification Line ❑ Repair ❑ Expansior
PROPERTY LOCATION: C%i
Name: (owner) SUBDIVISION 1 LOT # t�3
System Installer: 'v-�rt,,Registration #
Basement with plumbing: ❑ Garage )X Number of Bedrooms 3
Type of Water Supply: ❑ Community X Public ❑ Well Distance from well feet
System Type: 5 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.
anis system nas oeen mstauea in compnance wun appncame Norm tarouna lieneras matutes, naves tor sewage ireatment and msposai, and an conditions of the
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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 ❑ Noy,
If yes, see attached sheet for additional operation conditions, maintenance and reporting.
IV. Operation:
V. Other:
Permit and lonstructlon Autnonzation.
❑ D -Box ❑ Pump ❑ Alarm ❑ H2OLine ❑ PWR Line
Following are the specifications for the sewage disposal system on the above captioned property.
Type of system: El Conventional Others cam. Septic Tank: I~000 gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches„ 1 of each ditch 15 b feet ditches F feet ditches inches
French Drain Required: _ � "CrLinear feet
Authorized State Agent `� ` ` \\ Date 0,I 0415"
t 5-S--3 63�