OPHTE#/� -s— s-72 Harnett County Department of Public Health 24236
PERMIT # 96952 Operation Permit
Cts' New Installation Septic Tank 1"itrification line ❑ Repair ❑ Expansion
PROPERTY LOCATION q 01 /W
Name: (owner)SUBDIVISION LOT #
System Installer: fa Cyd &'�, Registration #
Basement with plumbing: ❑ Garage _� �tuber of Bedrooms 14
Type of Water Su ply: /❑ Community 21 Public ❑ Well Distance from well feet
System Type: a�.0 l"t /A L.� i p T o a– /j Types V and VI Systems expire in S years.
(In accordance with able V a) 07ner mus6atf Department 6 months prior to expiration for permit renewal.
INIs 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
NC %�S CSV 1% a v )�
VL-
/VV
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3�
V
PERMIT CONDITIONS
I. Performance: System shall perform in accordance with Rule .1961.
11. Monitoring: As required by Rule .1961.
III. 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 ❑ H2O1-ine ❑ PWR Line
Following are the specifications for the sewn `LSA disposal system on the above captioned property.
Type of system: ❑ Conventional PJ Other 12 /5 V �— Septic Tank: / UD 0 gallons Pump Tank: 17-10 0 gallons
Subsurface �N f exact length width of depth of
Drainage Field ditches of each ditch { ZD feet ditches 3 feet ditches 26 inches
French Drain Requiret-- ear feet
Authorized State Agent Date sT 1 a
16-5-38972 (1) 16-5-38972 (2) 16-5-38972 (3) 16-5-38972 (4) 16-5-38972 (5)
7
16.538972 (6) 16-5-38972 (7) 16-5-38972 (8) 16-5-38972 (9) 16-5-38972 (10)
16-5-38972 (11) 16-5-38972 (12) 16-5-38972 (13) 16-5-38972 (14) 16-5-38972 (15)
vi
i
16-5-38972(16) 16-5-38972(17) 16-5-38972(18)