OP RHTE# i. -6 -39102 Harnett County Department of Public Health 24641
PERMIT # V0(1Operation Permit
f��lew Installation 12-�Septic Tank kation Line ❑ Repair ❑ Expansion
S�ev�4- lee Matorw— PROPERTY LOCATION: 1_4 ?5)
Name: (owner) eAton CiA. ane. SUBDIVISION LOT #
System Installer: Registration #
Basement with plumbing: ❑ Garageu�ff of Bedrooms
Type of Water Supply: ❑Community C3 -Public ❑ Well Distance from well feet
System Type: 33- Types V and VI Systems expire in S years.
(In accordance with Table V a) Owner musi6tcontact Health 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
PERMIT CONDITIONS
I. Performance: System shall perforin 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 ❑ H2OUne
❑ PWR Line
Following are the
specifications for the sewag�juilro sal
system on the above captionetprooperty.
—M—:
J� CpeaGC 1M(/of�
Type of system:
El Conventional
Conventional other
Zt
C5FI &�
Septic Tank S w gallons
Liu,
vl zr� 1351
Accom�a`�`c' l: tn.V
No. of
exact length
width of
depth of
I
ditches 3
of each ditch 100 feet
ditches feet
' If
)CS.G
Are..J
FCaetL-
J2�(a
AL rt A"` -(JA
PERMIT CONDITIONS
I. Performance: System shall perforin 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 ❑ H2OUne
❑ PWR Line
Following are the
specifications for the sewag�juilro sal
system on the above captionetprooperty.
—M—:
Type of system:
El Conventional
Conventional other
Zt
C5FI &�
Septic Tank S w gallons
Pump Tank gallons
Subsurface
No. of
exact length
width of
depth of
Drainage Field
ditches 3
of each ditch 100 feet
ditches feet
'/
ditches % Y inches
French Drain Required: Linear feet
Authorized State Agent Date 0-7113 / 00V7—
i
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