OPNTE# I1 — S" �Cj��S Harnett County Department of Public Health 24564
PERMIT At a°►�35 Operation Permit
New Installation �R Se tic Tank Nitrification Line El Repair El Expansion
PROPERTY LOCATION: 0%,if— oGx. eb
Name: (owner) CoV"r%co SUBDIVISION Womea. O, -v LOT # 6Po
System Installer. Lcag,-+ 51ay.Q, e Registration #
Basement with plumbing: ❑ Garage ❑ Number of Bedrooms 3
Type of Water Supply: ❑ Community �X Public ❑ Well Distance from well feet
System Type: Timed Types 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 Mont 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
I. 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 ❑ N
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 disposal stem on the above captioned property.
Type of system: ❑ Conventional Other 1 Irtf, aha N95 Septic Tank: 1000 gallons Pump Tank: gallons
Subsurface No. ofexact length width of depth of
Drainage Field ditches , of each ditch "14 0 feet ditches 3 feet ditches 211�3a inches
French Drain Required: ate Linear feet
Authorized State Agent "A3 Date 6 13