OP RRHTE# Z5 ---:;--3737W Harnett County Department of Public Health 24329
PERMIT # Z 0 % /
�� � 0 eration Per. � /
New Installation Septic Tank 2r Nitrification Line ❑ Repair ❑ Expansion
j PROPERTY LOCATION: <V1. Zyv3 Ac4,*,,A 1r4
Name: (owner) hed— SUBDIVISION LOT #
System Installer: rIDV AW) (i Registration #
Basement with plumbing: ❑ Garage ff Number of Bedrooms J
Type of Water Supply: ❑ Community El Public L)i Well Distance from well 140 �" feet
System Type: '/c s r v g Types V and VI Systems expire in S years.
(In accordance with Table V a) caner must contact Health Department 6 months prior to expiration for permit renewal.
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This system has been installed in compliance with applicable North Carolina General Statutes, Rules for
PERMIT CONDITIONS
I. Performance:
Il. Monitoring
III. Maintenance:
IV. Operation:
V. Other.
rfatment and Disposal, and all conditions of the Improver,
z f t'k,< l..v- b ,'Ltd
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.
Permit and Construction Authorization.
❑ 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:
El sew
; 5 /.. (1f�� Septic Tank: J 003 gallons Pump Tank: gallons
Subsurface No. of exact length width of _ depth of
Drainage Field ditches 3 of each ditch F feet ditches J feet ditches Z i inches
French Drain Required: Linear feet
Authorized StateAget�L ,a�'DT� r—�—� /y�/f�../7� 3r, Date _J Z —110'JG,
15-5-37373RR (2)
15-5-37373RR (7)
15-5-37373RR (3)
15-5-37373RR (8)
15-5-37373RR (4)
15-5-37373RR (9)
15-5-37373RR (5)
r
15-5-37373RR (1)
15-5-37373RR (6)