OPNTE# n -s-- 4aHarnett County Department of Public Health 24478
PERMIT # 2; 190 0 eration Per it —/
L�" New Installation Septic Tank Lid Nitrification Line ❑ Repair ❑ Expansion
/ PROPERTY LOCATION *—r7o 3 Ci&)a— � .2wf6
Name: (owner) .TQC SUBDIVISION LOT #
System Installer: d1=e Registration #
Basement with plumbing: ❑ Garage Number of Bedrooms
Type of Water Supply: ❑ Community Public ❑ Well Distance from well feet
System Type: Tic 6 a pes V and VI Systems expire in S years.
(In accordance with Table V a) Owner must contact ealth 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
CV
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32 1J41�
Yt6Mil LUNDIIIONl:
I. Performance: System shall perform in accordance with Rule .1961.
II. 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 ❑ 14201-ine
❑ PWR Line
Following are the
specifications for
the seewwaa disposal system on the above captioned property.
Type of system:
El Conventional
L� Uther Z!P/o
Septic Tank: I&& J gallons
Pump Tank gallons
Subsurface
No. of
exact length
width of
depth of
Drainage Field
ditches
3 of each ditch LOO feet
ditches_ feet
ditches_ inches
French Drain Required: Linear feet
Authorized State 9 Date :5 —30 I
17-5-40588 (1)
17-5-40588 (2)
17-5-40588 (3)
17-5-40588 (4)
17-5-40588 (5)
17-5-40588 (6)
17-5-40588 (7)
17-5-40588 (11) 17-5-40588 (12)
17-5-40588 (8)
17-5-40588 (9)
17-5-40588 (10)