OP RHTE# /S -S 36Harriet. %ounty Department of Public Hi--ith 23877
PERMIT # ZAg73 Operation — Permit —/
13/New Installation Ld Septic Tank Ld' Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION;�i�/3S.: .��
Name: (owner) tsc SUBDIVISION /'/a�Lrl-wLOT #_
System Installer: Registration #
Basement with plumbing: ❑ Garage>mber of Bedrooms 3
Type of Water Supply: ❑ Community Z Public ❑ Well Distance from well feet
System Type: 2 R ra ��ftwj* eA—J. � Types V and VI Systems expire in S years.
(In accordance with Table V a) Owner must cKtact Health Department 6 months prior to expiation for permit renewal.
This system has been installed in compliance with applicable North Camlina General Statutes, Pules for Sewage Treatment and juprml, and all conditions of the Imprirement Permit and construction Authorization.
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 ❑ H20Line
❑ PWR Line
Following are the
specifications for the sewage disposal
system yo the/ab^oye captioned property.
"F
J
Type of system:
❑ Conventional Other
��o C�•r�•�� V'
Septic Tank i00 gallons
Pump Tank /OOP gallons
Subsurface
No. of
/
exact length
width of
depth of .a
13�3'
Drainage Field
ditches
of each ditch 3/<!F� feet
ditches feet
ditches inches
French Drain Required: Linear feet
Authorized State Ag!�,���Date >' 23 - /�
r4 I
LL15 5 3646OR (1)
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r
15-5-3646OR (2)
15-5-3646OR (6)
�Q c.a is -A--4
15-5-3646OR (7)
r l
15-5-3646OR (3)
:7.,
15-5-3646OR (8)
15-5-3646OR (4)
15-5-3646OR (5)
15-5-3646OR (9)
15-5-36460R (11)
15-5-3646OR (12)
15-5-3646OR (13)
15-5-36460R (14)
15-5-3646OR (10)