OPHTE#
Harnett
County Department of Public Health
24269
PERMIT# T87ra'
Operation Permit
"trification
IR New Installation c Tank line
❑ Repair ❑ Expansion
PROPERTY LOCATION:a.sazs GC aG�� �s
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Name: (owner)
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SUBDIVISION—/uGv�rrr�
LOT # LM
System Installer:1 a�a t� J t"� Registration #
Basement with plumbing: ❑ Garage lumber
of Bedro
s
Type of Water Supply: ❑ Community L�1
Public ❑ Well
Distance from well feet
System Type:
qp,Types
V and VI Systems expire in S years.
(In accordance with Table V a) k
Owner must con Health Department 6 months prior to expiration for permit renewal.
This system has been installed in compliane with applicable North Carolina General Statutes, Rules for Sewage Treatment and Disposal, and all conditions of the Improvement Permit and Construction Authorization
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PERMIT CONDITIONS
1. Performance: System shall perform in accordance with Rule .1961.
Il. 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 ❑ H2OLine ❑ PWR Line
Following are the specifications for the sewage disposal system on the above captioned property.
Type of system: ❑ Conventional ❑ Other Z$`%xa AA.A e -0-y., SaxGa— Septic Tank /tea gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches of each ditch 10 b feet ditches 3 feet ditches ZO„ inches
French Drain Required: Linear feet
Authorized State Agel%_:�a- C' % �.�r� � Date l -
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16-5-39050 (1)
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16-5-39050 (6)
16-5-39050 (2)
16-5-39050 (3)
16-5-39050 (7) 16-5-39050 (8)
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16-5-39050 (12)
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16-5-39050 (13)
16-5-39050 (4)
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16-5-39050 (5)
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16-5-39050 (9) 16-5-39050 (10)