OP RHTE#11 �+0+►�1'�6i Harnett County Department of Public Health 24542
PERMIT # ��1� Operation Permit
New Installation Septic Tank Nitrification Line ElRepair El Expansion
pp PROPERTY LOCATION: CvrE59VIZ.4 p9& i_o
Name: (owner) _ I a,\e.NsLG NQys� k9AS SUBDIVISION LOT # 514
System Installer: NoeioC.'e, Registration #
Basement with plumbing: ❑ Garage 'j< Number of Bedrooms 3
Type of Water Supply: ❑ Community U Public ❑ Well Distance from well feet
System Type: —V -Ll 1Types V and VI 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 Norm 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.
11. Monitoring: As required by Rule .1961.
III. Maintenance: As required by Rule .1961. Other.
Subsurface system operator required? Yes ❑ Nox
If yes, see attached sheet for additional operation conditions, maintenance and reporting.
IV. Operation:
V. Other.
❑
D -Box
❑ Pump ❑ Alarm ❑
H20Line ❑ PWR Line
Following are the
specifications for
the sewage disposal system on the above captioned property.
Type of system:
11Conventional
, Other Pvnz \ o EZ Erre ,r! Septic Tank: s 600
gallons Pump Tank 10 o d gallons
Subsurface
No. of
exact length width of
depth of
Drainage Field
ditce��
3 of each ditch 5 feet ditches 3
feet ditches inches
French Drain Required: _ _
n\ ',Lislear Net
Authorized State Agent Date
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17-S-tiQL,O3Gt