OP RHTE# Harnett County Department of Public Health
23913
PERMIT # 2834b 0 eratlon Permit
LJ New Installatic Tank LT Nitrification Line ❑ Repair ❑ Expansion
_ PROPERTY LOCATION::5,itW7 /Zft� uuY'S XQ)
Name: (owner) SUBDIVISION Gtp--.(1- LOT # Z8
System Installer: Fir,. Registration #
Basement with plumbing: ❑ Garage Number of Bedrooms 3
Type of Water Supply: ❑ Community i�Public ❑ Well Distance from well feet
System Type: 1 S°d/�
�r G-�d'Lt N Types V and VI Systems expire in S years.
(In accordance with Table V a) Own/ er must contact"lealth 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 Disposal, and all conditions of the Improvement Permit and Construction Authorization
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PERMIT CONDITIONS:
I. Performance:
ll. 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 -Boz
❑ Pump ❑
Alarm ❑ 1-1201-ine ❑ PWR Line
Following are the
specifications for
the sewa,ge disposal system on the above captioned property.
Type of system:
❑ Conventional
f3 Other L5'02- iLSIL u
Septic Tank: 1066 gallons Pump Tank: gallons
Subsurface
No. of
exact length
width of depth of
Drainage Field
ditches
2 of each ditch I zd feet
ditches 3 feet ditches 20 inches
French Drain Required: Linear feet /
Authorized State AgeFf� _.'' ��>Date
L,
mmmmm
14-5-35208R (1) 14-5-35208R (2) 14-5-35208R (3) 14-5-35208R (4) 14-5-35208R (5)
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14-5-35208R (6) 14-5-35208R (7) 14-5-35208R (8) 14-5-35208R (9) 14-5-35208R (10)
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14-5-35208R (11) 14-5-35208R (12) 14-5-35208R (13) 14-5-35208R (14) 14-5-35208R (15)
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14-5-35208R (16) 14-5-35208R (17) 14-5-35208R (18)