OP-Cannot sign off on other permits have not been picked upHTE# 1-7— ::� V:; 8 Harnett County Department of Public Health 24482
PERMIT # x
144 0 eration Pe It
Lid" New Installation Tank L/Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION_SL77,3 S ,26
Name: (owner)_1A/D.9S SUBDIVISION LOT #
System Installer: C C/ Registration #
Basement with plumbing: ❑ Garage ❑ Number of�Bedms
Type of Water Supply: ❑ Community El Public LN Well Distance from well /oma �'� feet
System Type: 1�v�p d + ZS% 4lcA yc La Tync Sze Types V and VI Systems expire in S years.
(In accordance with T9ble V a) 'zner must contact Health Department 6 months prior to expiration for permit renewal
This system has been installed in compliance with applicable Nord Carolina General Statutes, Rules for Sewage Treatment and Disposal, and all conditions of the Improvement Permit and construction Authorization
PERMIT CONDITIONS
1. Performance:
Il. Monitoring:
III. Maintenance:
IV. Operation:
V. Other.
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System shall perform in accordance with Rule .1961.
As required by Rule .1961.
As required by Rule .1961. Other:
Subsurface system operator required? Yes ❑ No ❑
If yes, see attached sheet for additional operation conditions, maintenance and reporting.
❑ D -Box ❑ Pump ❑ Alarm ❑ H2OLine ❑ PWR Line
Following are the specifications for the sewagC disposal system on the above ca tioned property.
Type of system: ❑Conventional Cs�' Other Z�3a �`P1'� Septic Tank /00 0 gallons Pump Tank: /000 gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches 2�. of each ditch 1 O p feet ditches _2 feet ditches Z U inches
French Drain Required: Linear feet
Authorized State A Li+ ��, �$ Date (,
F�17 m m
I=
17-5-40988 (1) 17-5-40988 (2) 17-5-40988 (3) 17-5-40988 (4) 17-5-40988 (5)
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1)
17-540988 (11) 17-5-40988 (12) 17-5-40988 (13) 17-5-40988 (14) 17-5-40988 (15)
ma -
17 -5-40988 (16) 17-540988 (17)