OP RHTE# Harnett County Department of Public Health 23768
PERMIT # Operation Permit �(
New Installation LNt Septic Tank )1 Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION:
Name: (owner) �cevvy LLC SUBDIVISION Ke- t_a.>.s 'FP%9. R5 LOT # 5 )
System Installer: Hpv4A\—a sc-R-1vN C— Registration #
Basement with plumbing: ❑ Garage Number of Bedrooms �—
Type of Water Supply: ❑ 11almy. Public ❑ Well Distance from well IA tJ feet
System Type: Types V and VI Systems expire in S years.
(in accordance with Table V a) Owner must contact Health Department 6 months prior to expiration for permit renewal.
Ibis system has been installed in compliance with applicable North Carolina General Statutes, Rules for Sewage Treatment and Disposal, and all conditions of the Improvement Permit and Construction Authorization
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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.
�ceSvAs No; ov�Ep �� sena CSF aus�wsa.4cS�orJ
❑ D -Box ❑ Pump ❑ Alarm ❑ H2OLine ❑ PWR Line
Following are the specifications for the sewage disposal system on the above captioned property.
Type of system: ❑ Conventional _X Other E _ Vj_oma., Septic Tank: 1000 gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of
Drainage field ditches 1 of each ditch —1x"10 feet ditches ? feet ditches W 7 inches
French Drain Required: Linear feet
Authorized State Agent > 4v\4 Date T L yS