OPHTE#
Harnett
County Department of Public Health
24205
PERMIT # 243063
the sewa$a disposal system on the above captioned property.
0 4
CYatl�Se
Type of system:
❑ Conventional
f�" Other 2'3`/b yZ�'`a�-- Septic Tank: !o
Installation ' Septic Tank Nitrification Line
d Neww �
❑ Repair El Expansion
No. of
exact length width of
PROPERTY LOCATION: �i��i �-Oieh
Drainage Field
2
Name: (owner) _ 41AJJe�
SUBDIVISION k1As ?�
LOT # �19
System Installer: -)
Registration #
Basement with plumbing: ❑ Garage
—/Number of Bedrooms 3
❑ from feet
Type of Water Supply: ❑ Community
tsd Public
Well Distance well
System Type: 2S Sloe
€� 1 rnn�1
- 6 C Types V and A Systems expire in S years.
(In accordance with Table V a)
Owner must contact Health Department 6 months prior to expiration for permit renewal.
PERMIT CONDITIONS:
I. Performance: System shall perform in accordance with Rule .1961.
11. Monitoring: As required by Rule .1961.
111. Maintenance: As required by Rule .1961. Other.
Subsurface system operator required? Yes ❑ No ❑
If yes, see attached sheet for additional operation conditions, maintenance and reporting.
IV. Operation:
V. Other:
❑
D -Box
❑ Pump ❑ Alarm ❑
H2OLine ❑ PWR Line
Following are the specifications for
the sewa$a disposal system on the above captioned property.
0 4
Type of system:
❑ Conventional
f�" Other 2'3`/b yZ�'`a�-- Septic Tank: !o
gallons Pump Tank: gallons
Subsurface
No. of
exact length width of
depth of
Drainage Field
ditches
3 of each ditch �_ feet ditches 3
feet ditches ZU->t8 inches
French Dain Required: Linear feet
Authorized State Age Date
16-5-38565 (2)
16-5-38565 (7)
16-5-38565 (3) 16-5-38565 (4)
-4
16-5-38565 (8)
16-5-38565 (5)
16-5-38565 (6)
16-5-38565 (2)
16-5-38565 (7)
16-5-38565 (3) 16-5-38565 (4)
-4
16-5-38565 (8)
16-5-38565 (5)