OPHarnett County Department of Public Health 24508
PERMIT # 207185— Operation Permit �/,
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New Installation 9 Septic Tank 3+ Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION10 2Z
Name: (owner) STA-.Uca=/ SrirJ ,s 7t1c SUBDIVISION LOT # 7
System Installer: CiEwr Registration #
Basement with plumbing: ❑ Garage � �mber of Bedrooms 3
Type of Water Sup ly: 1:1 Community I� Public E-1WellDistance from well feet
System Type:XAA,SOG- Types V and VI Systems expire in S years.
(In accordance with Table V a) Owner in contact Health Department 6 months prior to expiration for permit renewal.
IDis system has been installed in compliance with applicable North Carolina General stabiles, Rules for Sewage Treatment and Disposal, and all conditions of the Improvement Permit and Construction Authorization
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PERMIT CONDITIONS: c('
I. Performance:
If. Monitoring:
III. Maintenance:
IV. Operation:
V. Other.
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 ❑
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H2OLine ❑
PWR Line
Following are the specifications for the sewa,R� disposal system on the above captioned property.
Type of system: ❑ Conventional f3 Other -Z "'Vii, 0CA,-_T a {T,._ Septic Tank: t oo J gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches I of each ditch SOD feet ditches 3 feet ditches inches
French Drain Required: Linear feet
Authorized State Age Date c/ -/5—/7
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