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OPHTE# T �-s-y Ts3LJ Harnett County Department of Public Health 24733 PERMIT # 2.543 Operation Permit New Installation X Septic Tank X Nitrification Line ❑ Repair ❑ Expansion PROPERTY LOCATION: Gax Nit 190 Name: (owner) 1r�ocna� �azass SUBDIVISION LOT # System Installer: 9 v a vKcbo S GP e;'. C— Registration # Basement with plumbing: ❑ Garage ❑ Number of Bedrooms ,* Type of Water Supply: ❑ Communi ❑ Public ,K Well Distance from well S OO feet System Type: J 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. [his system has been installed in compliance with applicable North Carolina General Statutes, Rules for Sewa a Tre etrcnt and Disposal, and all conditions of the Improvement Permit and Construction Authorization. © ARbp� r F r v ¢6 6" 6?.'LP.(e Vi0 yg f O E 16 GqK eA 1 V PERMIT CONDITIONS: I. Performance: System shall perform in accordance with Rule .1961. II. Monitoring: As required by Rule .1961. 111. 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 ❑ H2OLine ❑ PWR Line Following are the specifications for the sewage disposal,.ss stem on the above captioned4roperty. Type of system: ElConventional Other Septic Tank: t 06 0gallons Pump Tank: gallons Subsurface No. of exact length width of depth of Drainage field ditches T of each ditch 3 feet ditches 3 feet ditches �_ inches French Drain Required: Linear feet Authorized State Agent DEN5 Date h 1 � J.i�• V �� y Yr Mr V! it (1 �� ; �� `` :.; } , � } • „ � �- , � � �:',� .: �� ry• � �`�. .tr y °�'�� I Fj �S, ��l�n ' S Yv ' �� a ��. S', tr. z 7, i S t IuL�° F ii(li��/�/�y� ("i// 1, i +p r'`i Je jf apT Ey /i �� y yyy( f