OPHTE#05'-S - z3r-7U Harnett County Department of Public Health 21 0 6 6
PERMIT # z s7as / 0 eration--Pe miitt
2 New Installation Septic Tank ❑ Repair Nitrification Line ❑
_.3crs'y3 s.Yy,~ Aj~ Expansion
PROPERTY LOCATION:
Name: (owner) K--,w.4- /,4SUBDIVISION LOT #
System Installer. 6~ Registration #
Basement with plumbing. ❑ Garage Number of B rooms __3_-
Type of Water Supply: ❑ Community Z Public Well Distance from well feet
System Type: Cewr- = Types V and VI Systems expire in 5 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.
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PERMIT CONDITIONS:
I. Performance: System shall perform in accordance with Rule .1961.
II. 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.
Following are the ssppecc tions for the sewage disposal system on the above captioned property.
Type of system: Ltit Conventional ❑ Other
Subsurface No. of exact length
Drainage Field ditches of each ditch ' ° feet
French Drain Required: linear feet
Authorized State
Septic Tank: _ gallons Pump Tank: gallons
width of depth of
ditches feet ditches yo inches
Date 16-15-10
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