OPHTE# 15" S�7a�el
PERMIT # QtC6:�L\
Name: (owner) 'X> 1
System Installer: W w
Basement with plumbing: ❑
Type of Water Supply: ❑ Co
System Type:
(In accordance with Table V a)
in
Harnett County Department of Public Health 24014
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Garage `.>�l Number of Bedrooms
unity Public ❑ Well
Operation Permit
New Installation Septic Tank Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION: Ti 66N V D
SUBDIVISION PwM0 A.5 YiDN r , LOT #55
Registration #
a from well �n O feet
Types V and VI Systems expire in 5 years.
must contact Health Department 6 months prior to expiration for permit renewal.
with aoolioble North Carolina General Statutes. Rules for Sewage Treatment and DinoosaL and all conditions of the
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CALaBcw -Of
PERMIT CONDITIONS:
I. Performance: System shall perform in accordance with Rule .1961.
Il. Monitoring: As required by Rule .1961.
111. Maintenance: As required by Rule .1961. Other:
Subsurface system operator required? Yes ❑ NOX
If yes, see attached sheet for additional operation conditions, maintenance and reporting.
IV. Operation:
V. Other.
Permit and Construction Authorization.
❑ D -Box ❑ Pump ❑ Alarm ❑ H2OLine ❑ PWR Line
Following are the specifications for the sewage disposal system on the above captioned prop�fr�rt�''
Type of system: 71 Conventional Other Qv*he T" Cj�Pa+106CL lC Q' Septic Tank: 10 0 0 gallons Pump Tank 1000 gallons
Subsurface No, of exact length width of depth of
Drainage Field ditches' T' of each ditch 1 50 feet ditches feet ditches 5S-3(5 inches
French Drain Required: LD&Ueet
Authorized State Aeent )% Date �7