OPNTE# iHarnett County Department of Public Health 24226
PERMIT # ZSSo-7 /Operation Permit
New Installation Septic Tank VNitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION;jt/9Da DiDiZ-�
Name: (owner) Zftag ( _PVAA'&'_ SUBDIVISION 1",a= 4021d,70� LOT # ?o
System Installer. Sv..svee Registration
Basement with plumbing: ❑ Garage umber of Bedrooms
Type of Water Supply:munity Public ❑ Well Distance from well feet
System Type: ❑ComT 7n"CG rZ 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 Authoritarian
PERMIT CONDITIONS
I. Performance:
11. Monitoring:
III. Maintenance:
IV. Operation:
V. Other.
V
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PERMIT
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System shall perform in accordance with Rule .1961.
As required by Rule .1961.
As required by Rule .1961. Other:
Subsurface system operator required? Yes ❑ No ❑
If yes, see attached sheet for additional operation conditions, maintenance and reporting.
❑ D -Box ❑ Pump ❑ Alarm ❑ H2OLine ❑ PWR Line
Following are the specifications for the sews disposal system on the above captioned property.
Type of system: ❑ Conventionalf sl Other 7! �A A660 (_7'7j--%_ Septic Tank / cX)0 gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches Z of each ditch 20 feet ditches 3 feet ditches tg inches
French Drain Required: Linear feet
Authorized State Age /:�,= Z .. S Date 5'— 00 - /Co
16-5-38858 (1) 16-5-38858 (2) 16-5-38858 (3) 16-5-38858 (4) 16-5-38858 (5)
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16-5-38858 (6) 16-5-38858 (7) 16-5-38858 (8) 16-5-38858 (9) 16-5-38858 (10)
16-5-38858 (11) 16-5-38858 (12) 16-5-38858 (13) 16-5-38858 (14) 16-5-38858 (15)
16-5-38858 (16) 16-5-38858 (17) 16-5-38858 (18) 16-5-38858 (19) 16-5-38858 (20)
14-
16-5-38858 (21)