OPHTE# /6 S 387- It Harnett County Department of Public Health
24065
PERMIT # —/ Operation Permit
LRT New 'Installation c Tank ER' Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION: /e)oG oiv S7A&6— /cp
Name: (owner) /X✓fe'KG /�cosu- c�j SUBDIVISION O`X4zee6.) r 5- LOT # I
System Installer: C /jw S Registration #
Basement with plumbing: ❑ Garage G;/Number of Bedrooms 3
Type of Water Supply: ❑ Community 19/ Public ❑ Well Distance from well feet
System Type: ?---n-6 Rf?
1?I/, .
16-5-38211 (1) 16-5-38211 (2) 16-5-38211 (3) 16-5-38211 (4) 16-5-38211 (5)
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L7
16-5-38211 (6) 16-5-38211 (7) 16-5-38211 (8) 16-5-38211 (9) 16-5-38211 (10)
16-5-38211 (11) 16-5-38211(12) 16-5-38211 (13) 16-5-38211 (14) 16-5-38211 (15)
16-5-38211 (16) 16-5-388211(17) 16-5-38211 (18) 16-5-38211 (19)