OPNTE# 11-64+07,9Z Harnett County Department of Public Health 24644
PERMIT # 7-gAZ 0veration Perm't
New Installation Septic Tank I;�'Nitrtfication Line ❑ Repair ❑ Expansion
PROPERTY LOCATION: SJ44ln, !td 5a 140r9J
Name: (owner) CG Q4V% t: nTLrf65e_ SUBDIVISION LOT # 116
System Installer: 86 V 5 Registration #
Basement with plumbing: ❑ Garage Number of Bedrooms 'S
Type of Water Supply: ❑ Community B!!!lit��� El Well Distance from well feet
System Type: 25�� 2�d ar �. aG 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 applinble Noah Carolina General Stumms, Rules for Sewage Treatment and Disposal, and all conditions of the Improvement Permit and Construction 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 ❑ No EK
If yes, see attached sheet for additional operation conditions, maintenance and reporting.
IV. Operation:
Other.
❑ D -Box ❑ Pump ❑ Alarm ❑ H2OLine ❑ PWR Line
Following are the specifications for the sewage disposal system an the above captioned property.
Type of system: ❑ Conventional Ld�Oiher Septic Tank:tyar-1 gallons Pump Tank gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches of each ditch S feet ditches 3 feet ditches )84,Y -',ZZ inches
French Drain Required: Linear feet
Authorized State Agent ,-._1���i' Date