OPHTE# Ao— S —3971.0 Harnett County Department of Public Health 24231
PERMIT # 288 7r0 eration Per It
iNew InstallationSeptic Tank LO/Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION:34z/57154&c,we id4
Name: (owner) .�ui��-Ti�G SUBDIVISION /1,A,0� �er,�<e LOT # /1
System Installer: . ct L # Registration #
Basement with plumbing: ❑ Garageumber of Bedrooms
Type of Water Supply: ❑ Community I�ublic ❑ Well Distance from well feet
System Type: . D u? C iZ 4411 Types V and VI Systems expire in S years.
(In accordance with Table V a) ` Owner t contact Health Department 6 months prior to expiration for permit renewal.
has been installed in compliance kith applicable NorthT3roNnaGeneral Statutes, Rules for Sewage Treatment and Disposal, and all conditions of the Improvement Permit and Construction Authorization
PERMIT CONDITIONS
I. Performance:
II. Monitoring:
III. Maintenance:
IV. Operation:
V. Other:
lz�C
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 sew a disposal
system on the above captioned property.
Type of system:
❑ Conventional (Other 23°/a
/�f��UftZpi
Septic Tank: lboo gallons Pump Tank: gallons
Subsurface
No. of
exact length
width of depth of
Drainage Field
ditches
of each ditch T o o feet
ditches 3 feet ditches 2y inches
French Drain Required: Linear feet
Authorized StatenAr� iL. L_ 11L A__ ��� Date 1° - H —
16-5-38760 (1) 16-5-38760 (2) 16-5-38760 (3)
s%" M
16-5-38760 (4)
16-5-38760 (5)
16-5-38760 (6)
16-5-38760 (7)
16-5-38760 (8)
16-5-38760 (11) 16-5-38760 (12) 16-5-38760 (13)
16-5-38760 (9)
16-5-38760 (10)