OPHTE# 1-7-S--" 06CiHarnett County Department of Public Health 24470
PERMIT # Operation Permit
New Installation Septic Tank �2( Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION: W I Lvr,r` s
Name: (owner) L�— •ter v CIO SUBDIVISION S wccz wo LOT #
System Installer: SEe; \ c. Registration #
Basement with plumbing: ❑ Garage 'S� Number of Bedrooms --
Type of Water Supply: ❑ Commune X Public ❑ Well Distance from well feet
System Type: o' 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.
Has 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 Authoritarian
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PERMIT CONDITIONS
I. 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 ❑ 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 sewage cispos I system o the above captioned property.
Type of system: ❑ Conventional X Other Z �t-o� Septic Tank: l o Pl gallons Pump Tank: gallons
Subsurfaceo. of exact length width of depth of
Drainage Field ditche Y of each ditch �-i cj feet ditches 3 feet ditches �f8'`� a inches
French Drain Required: \ ear feet
Authorized State Agent Date