OP RHTE# lS —�—�LiR�iL Harnett County Department of Public Health 23820
PERMIT # Z09 / Operation Per It
[?/New Installation c Tank W Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION:
3Liyj-9 ��Q�
Name: (owner) �t�,_ �e 1� G SUBDIVISION A6+ae.P— r>r> aT LOT # I IR
System Installer. I& Registration #
Basement with plumbing: ❑ Garage�mber of Bedrooms 3
Type of Water Supply: ❑ Community 13 Public ❑ Well Distance from well feet
System Type: L5•i6%1�/X+-r�'t1i..Sr-�s, IvL, T1,we.� 4i �Ztlp�V and VI Systems expire in S years.
(In accordance with Table V a) r Owner must contact alth Department 6 months prior to expiration for permit renewal.
Ibis system has been Installed In tomphana with 9pluablet Permit and Construction Authorization.
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PERMIT CONDITIONS
I. Performance:
If. Monitoring:
III. Maintenance:
IV. Operation:
V. Other.
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 sewss disposal system on the above captioned properly.
Type of system: El Co ❑� Other Septic Tank 100 0 gallons Pump Tank: / •a 6 gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches of each ditch 33045 feet ditches 3 feet ditches 14— Ict inches
French Drain Required: Linear feet
Authorized State Ag� ,erDate
15-5-36875R (1) 15-5-36875R (2) 15-5-36875R (3) 15-5-36875R (4) 15-5-36875R (5)
15-5-36875R (6) 15-5-36875R (7) 15-5.36875R (8) 15-5-36875R (9) 15-5-36875R (10)
l
` d
15-5-36875R (11) 15-5-36875R (12) 15-5-36875R (13) 15-5-36875R (14) 15-5-36875R (15)
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f �. .�
15-5-36875R (16)
MONO$*
R (20)
4
15-5-36875R (21) 15-536875R (22) 15-5-36875R (23) 15-5-36875R (24) 15-5-36875R (25)