OPHTE# 15-5--313-10 Harnett County Department of Public Health 24011
PERMIT # aa$f, is Operation Permit
New Installation 'tK Septic Tank Nitrification Line ❑ Repair ❑ Expansion
p PROPERTY LOCATION:
Name: (owner) 1Ylt�¢cc—SQ�t Pvtt� ,5 SUBDIVISION Mmc>_-c61 LOT # K5-,4,
System Installer: EooNE, Gpr"-,&SRegistration #
Basement with plumbing. ❑ Garage Number of Bedrooms 36
Type of Water Supply: ❑ Community Public ❑ Well Distance from well feet
System Type: I 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.
this system has been installed in compliance with applicable Nonh 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.
11. Monitoring As required by Rule .1961.
III. Maintenance: As required by Rule .1961. Other.
Subsurface system operator required.? Yes ❑ N
If yes, see attached sheet for additional operation conditions, maintenance and reporting.
IV. Operation:
V. Other.
❑ D -Box ❑ Pump ❑ Alarm ❑ H20Line ❑ PWR Line
Following are the specifications for the sewage disposal stem on the above captionedFerry.
Type of system: ❑ Conventional Other 'CnBF-Q �C IA- Septic Tank: 1000 gallons Pump Tank gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches V of each ditch ISO feet ditches 3 feet ditches "3L inches
French Drain Required: Linear feet
Authorized State Anent r— A5 Date 4 bl:7116
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