OPHTE #/7-3 y/Z/y Harnett County Department of Public Health 24774
PERMIT # ,—I:i / Operation Permit
ra New Installation Rr Septic Tank ❑ Nitrification Line ❑ Repair ❑ Expansion
_ PROPERTY LOCATIO&3X/ 70 s a D Q2h
Name: (owner)iln'av� n74� SUBDIVISION LOT #
System Installer:—5LAA5S 5ACAiLl Registration #
Basement with plumbing: ❑ Garage —/Number of Bedrooms J
Type of Water Su pl : ❑ Community laJ Public El Well Distance from well feet
System Type: A01+/ �/ 7' — 6 <Z Types V and VI Systems expire in S years.
(In accordance with Table V a) Owner must con t alth Department 6 months prior to expiration for permit renewal.
This
PERMIT C DI
1. Pe rn
II. Mo ito
III. Ma' tel
IV. 0 ral
V. Ot r.
Following tre
Type of system:
Subsurface
Drainage Field
been installed in
North Carolina General Statutes. Rules for
Treatment and Disnosal. and
System shall perform in accordance with Rule .1961.
As required by Rule .1961.
As required by Rule .1961. Other.
Subsurface system operator required? Yes ElNo r-1If yes, see attached sheet for additional operation
cc
maintenance and
Permit and Construction Authorization.
DBox ElPump ❑ Alarm ❑ H2OLine 11the specifications for the sewage disposal system on the above wpuon
PWR Line
❑ Conventional 1Z Other22�& U Gt—(Oi Septic T nk s div gallons Pump Tank gallons
No. of exact length width of depth of
ditches I of each ditch / feet ditches 3 feet ditches Z `l a / 8 inches
French Drain Required: Linear feet����//
Authorized State Authorized State Agd4�� /' IfiTTGG /?��5 pate �( ^ l cl — l/ ` IfiNGG /?��5 Date �I ^ / cl — / -7
:L
17-5-41214(l) 17-5-41214(2) 17-5-41214(3) 17-5-41214(4) 17-5-41214(5)
r
17-5-41214(6) 17-541214(7) 17-5-41214(8) 17-5-41214(9) 17-541214(10)
17-5-41214(11) 17-5-41214(12) 17-5-41214(13) 17-5-41214(14) 17-5-41214(15)
�i
17-5-41214(16) 17-5-41214(17) 17-5-41214(18)