OPNTE# 1(0-5-46C)IS Harnett County Department of Public Health 24546
PERMIT # a la Operation Permit
New Installation N Septic Tank Nitrification Line ❑ Repair ❑ Expansion
'` , ^/ PROPERTY LOCATION: Do C'sv
Name: (owner) M4� kot"�S i+ SUBDIVISION QLOT # 1
System Installer. Z -o •max c GPrL_r4G2 Registration #
Basement with plumbing: ❑ Garage '-,' Number of Bedrooms lo�— A
Type of Water Supply: ❑ Community. X Public ❑ Well Distance from well t 00 feet
System Type:Types V and VI Systems expire in S years.
(In accordance with Table V a) Mb Owner must contact Health Department 6 months prior to expiration for permit renewal.
Ims ! stem has been installed in compliance with applicoble North Camlina General Statutes, Rules for Sewage Treamsent and Disposal, and all mnditiom of the Improvement Permit and Conammon Authorization.
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PERMIT CONDITIONS:
Performance: System shall perform in accordance with Rule .1961
Monitoring: As required by Rule .1961.
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 ❑ H2OLine ❑ PWR Line
Following are the specifications for the sewage disposj,system on the abov capti d property.
Type of system: 11 Conventional I Other t_,v- .Fr LQi—Septic Tank 180 V gallons Pump Tank gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches of each ditch J �w feet ditches 3 feet ditches 18 �� nches
French Drain Required: Linear feet
Authorized State Agent Date
I �- 5- qo(z1s