OPHTE# IG —S -3918U Harnett County Department of Public Health
PERMIT # 7 -'?9 z3 0 eration Perm24432
New Installation Septic Tank Vitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION: /A+ V� Xs �
Name: (owner) 2oi�T Uuks ds�b GrS SUBDIVISION Alt�rti� V;TI4 LOT #
System Installer. i Registration #
Basement with plumbing. ❑ Garage� �Muu her of Bedrooms 34-
Type of Water Supply: ❑ Community C3/Fublic ❑ Well Distance from well feet
System Type: ZS i,, Types V and If Systems expire in S 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 CONDffIONS:
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1. Performance: System shall perform in accordance with Rule .1961.
If. Monitoring: As required by Rule .1961.
III. Maintenance: As required by Rule .1961. Other.
Subsurface system operator required? Yes ❑ Na
If yes, see attached sheet for additional operation conditions, maintenance and reporting.
IV. Operation:
V. Other.
❑
D -Boz
❑ Pump ❑
Alarm ❑
H2OLine ❑ PWR Line
Following are the specifications for
the seewwageisposal system on the above captioned property.
;
Type of system: ❑
Subsurface
Conventional
No. of
Other _25 �� 1 �cE,,,� L c^ `�
Se tic Tank �ouy
`- D
gallons Pump Tank gallons
Drainage Field
ditches
exact length gZ r -75
L17 -depth
width of
of
French Drain Required:
oeach ditch :'T ttZ feet
'! Linear feetf a3): 'TOTAL-
ditches 3
feet ditches `L`1
inches
Authorized State
M
Date