OPHTE# 14,5-579w(� Harnett County Department of Public Health 24068
PERMIT # Al (P 0 Operation Permit
C3/ New Installation 9 Septic Tank Q Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION: at-zZas - ✓I F -b
Name: (owner) J!aR.0 Nrti SUBDIVISION QC,I LOT # rn
System Installer: S Registration #
Basement with plumbing: ❑ Garage��umber of Bedrooms _q
Type of Water Supply: El Community Ld Public ❑ Well Distance from well feet
System Type: +IL Types V and VI Systems expire in S years.
(In accordance with Table V a) Owner must conlM Health Department 6 months prior to expiration for permit renewal.
PERMIT CONDITIONS:
I. Performance:
Il. Monitoring:
III, Maintenance:
IV. Operation:
V. Other.
Treatment and DRaosal. and all conditions of the Improvement Permit and Construction Authomation.
fl- ' lea -W,�' >
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 ❑
M1
1 -
H2OLine ❑
Following are the specifications for the sewa�F disposal s stem on the above captioned property.
Type of system: ❑ Conventional ❑ Other 7 r7�JSUGiZf/`- Septic Tank: l Zoo gallons Pump Tank:
Subsurface No. of exact length width of depth of
Drainage Field ditches 2 of each ditch /a " feet ditches 3 feet ditches Zy
French Drain Required: Linear feet
Authorized State Agent Lilt Date
PWR Line
gallons
inches
16-5-37846 (1) 16-5-37846 (2) 16-5-37846 (3) 16-5-37846 (4) 16-5-37846 (5)
16-5-37846(6) 16-5-37846(7) 16-5-37846 (8) 16-5-37846(9) 16-5-37846(10)
16-5-37846 (11) 16-5-37846(12) 16-5-37846(13) 16-5-37846 (14) 16-5-37846(15)
r
o�.
16-5-37846 (16) 16-5-37846 (17) 16-5-37846 (18) 16-5-37846 (19) 16-5-37846 (20)
- a
16-5-37846(21) 16-5-37846 (22) 16-5-37846 (23) 16-5-37846 (24) 16-5-37846 (25)
k,�d.
16-5-37846 (26)