OP RI7 5-3lP33�t�
HTE# Harnett County Department of Public Health 24073
PERMIT # Operation Permit
New Installation Septic Tank �? Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION: FazAh _OQ
Name: (owner) Sc>4vcf1Pv4 SUBDIVISION—) VIL:LAGE LOT # (-
System Installer: C) iifs S .n\GLAND Registration #
Basement with plumbing: ❑ Garageia Number of Bedrooms 3
Type of Water Supply: ❑ Community Public Well Distance from well feet
System Type: a� El
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.
Ibis system has been Installed in compliance with applicable north Carohna General Smutes, Rules for Sewage treatment and Disposal, and all conditions of the Improvement Permit and Comtmction Authorization,
kc7 SSE
R
i
r
C
PERMIT CONDITIONS
I. Performance: System shall perform in accordance with Rule .1961.
If. Monitoring: As required by Rule .1961.
III. Maintenance: As required by Rule .1961. Other:
Subsurface system operator required? Yes ❑ Noi
If yes, see attached sheet for additional operation conditions, maintenance and reporting.
IV. Operation:
V. Other.
❑ D -Box ❑ Pump ❑ Alarm ❑ H2OLine ❑ PWR Line
Following are the specifications for the sewage disposal system on the above captioned property.
Type of system: ❑ Conventional Other EZ. ;"i.eW Septic Tank: Ste' gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches 3 of each ditch 5 O feet ditches 3 feet ditches Ala -30 inches
French Dain Required:_ 'kiaear feet
Authorized State Aeent Date 5" i5'11
I