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OP RHTE# 14e-s-N57%9Harnett County Department of Public Health 24277 PERMIT # Operation Permit New Installation 'T�r Septic Tank V-41triffcation Line ❑ Repair ❑ Expansion (� PROPERTY LOCATION: V's 4.0`O W N 'QJ Name: (owner) SUBDIVISION C-t_y o 6 '�1 s,�TGs2 Soi LOT # Lf— System Installer: Lo. r",C JoN1sort Registration # Basement with plumbing: El Garage El Number of Bedrooms Type of Water Supply: ❑ Community X Public ❑ Well Distance from well i00 feet System Type: 73 ? Types 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. [his system has been insulled in compliance with applicable North Carolina General Statutes, Rules for Sewage Treatment and Disposal, and all conditions of the Improvement Permit and Construction Authorization. MG IoW N eD 1� PERMIT CONDITIONS I. Performance: System shall perform in accordance with Rule .1961. I. 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 sewage disposal system on the above captioned property. Type of system: ❑ Conventional Other E--)TLOJ+v Septic Tank 100 © gallons Pump Tank: gallons Subsurfacetches o�\ �L exact length width of depth of Drainage Field dif each ditch 23 � feet ditches 3 feet ditches I � inches French Drain Required: near feet Authorized State Agent N � t'axs Date _J914IT 6 At� .14