OP RHTE#_JS=5-343 S/Z Harnett County Department of Public Health 23918
PERMIT # dO erati�n Permit
2e�g7 C� Neww Installation EtKSeptic Tank Nitrification Line ❑ Repair EJ Expansion
PROPERTY LOCATION: zP;t_wvo o
Name: (owner) /Ava4v2 /3�1aa.0SUBDIVISION /yef(s LOT # iz8
System Installer: <%As. `n A41r , Registration #
Basement with plumbing: ❑ Garage l' Number of Bedrooms e"
Type of Water Supply: ❑ Community 2�'Public ❑ Well Distance from well feet
System Type: 2-M CT@t)ts t r&r 'f c—*s* Qom- Types V and VI Systems expire in S years. r.
(In accordance with Table V a) Owner must conAct 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 Disposal, and all conditions of the Improvement Permit and Construction Authomation
PERMIT CONDITIONS
I. Performance:
II. Monitoring:
III. Maintenance:
IV. Operation:
V. Other:
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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 sa disposal system on the above captioned property.
Type of system: Elewa Conventional Other 2s' 4 !t¢DucYLrN d'-rs Fa;.- Septic Tank: gallons Pump Tank gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches 9 of each ditch f yD feet ditches 3 feet ditches inches
french Drain Required: Linear feet
Authorized State Ag n . f�� h-� Date 3-I(� -! (o
z, w -- :•,a ''fir -+'sem ;,
15-5-36095R (1) 15-5-36095R (2) 15-5-36095R (3) 15-5-36095R (4) 15-5-36095R (5)
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15-5-36095R (6) 15-5-36095R (7) 15-5-36095R (8) 15-5-36095R (9) 15-5-36095R (10)
15-5-36095R (11) 15-5-36095R(12) 15-5-36095R (13) 15-5-36095R (14) 15-5-36095R (15)
ty! 1
15-5-36095R (16) 15-5-36095R (17) 15-5-36095R (18) 15-5-36095R(19) 15-5-36095R (20)
15-5-36095R (21) 15-5-36095R (22) 15-5-36095R (23) 15-5-36095R (24)