OP RHTE #)G 53tg_�_6Z, Harnett County Department of Public Health
24276
PERMIT # �'�-6 0 eration Permit
New Installation Septic Tankitrification ne ❑ Repair ❑ Expansion
(� PROPERTY LOCATION: McKoy i ovvN
Name: (owner) SUBDIVISION CLvoc R6mSns;3,„ LOT #
System Installer: Lo. -",L Jct vso S Registration #
Basement with plumbing: ❑ Garage ❑ Number of Bedrooms -
Type of Water Supply: ❑ Community Public ❑ Well Distance from well LCO feet
System Type: � c 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.
This system has been installed in compliance with applicable North Carolina General Statutes, Rules for Sewage Treatment and Disposal, and all conditions of the Improvement Permit and construction Authorization
t30
rjL�1
uod+,E
t
f A)
f,t
'l
�C Y'oj CONN 9Q
rtRMII LUNDuIURS:
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 ❑ NaX
If yes, see attached sheet for additional operation a
IV. Operation:
Other.
maintenance and reporting.
❑ D -Box ❑ Pump ❑ Alarm ❑ H2OLine ❑ PWR Line
Following are the specifications for the sewage disposal �sYstem on the above captioned property.
Type of system: 11 Conventional X Other 2.. V19+v Septic Tank l00 o gallons Pump Tank: gallons
Subsurface Nora exact length width of depth of /
Drainage Field ditches of each ditch Q 0 feet ditches 3 feet ditches inches
French Drain Required: r feet
Authorized State Agent Date
4