OPHTE# 17 "5.4 0 -Mb Harnett County Department of Public Health 24598
PERMIT # 2`1413 Operation Permit
New Installation �K SeDytic Tank Nitrification Line El Repair ❑ Expansion
PROPERTY LOCATION: DOG V
Name: (owner) Co "s.�r''2y tic co-$ SUBDIVISION _O a;r-io t i N- LOT # 1q3—
System
$lSystem Installer: iiia Registration #
Basement with plumbing ❑ Garage` W Number of Bedrooms L
Type of Water Supply: ❑ Community Public ❑ Well Distance from well FOO; feet
System Type: a Types V and A Systems expire in S years.
(In accordance with Table V a) Owner must contact Health Department 6 months prior to expiration for permit renewal,
miss stem has been Walled in compliance nth applicable North Carolina General Statutes, Rules for Sewage Treatment and Disposal, and all conditions Df the Improvement Permit and Comwction Authorisation.
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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 ❑ 6
If yes, see attached sheet for additional operation conditions, maintenance and reporting.
IV. Operation:
V. Other.
❑ D -Boz ❑ Pump ❑ Alarm ❑ H2O1-ine ❑ PWR Line
Following are the specifications for the sewage disposals stem on the above captioned property.
Type of system: ❑ Conventional Other 2 Ft -O / Septic Tank: L 0 0 d gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of
Drainage Field dt ( of each ditch J feet ditches feet ditches �' inches
French Drain Required: linear feet
Authorized State Agent 'V�� ��� t*J Date
17- S -L{ o -ns