OPHTE# II—S—'4145S Harnett County Department of Public Health 24779
PERMIT # Z9N9t— Operation Permit
Ci"New Installation Q Septic Tank 2� Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION:aLioo6 e:)./-, s7;aaa B- 04D
Name: (owner)=vJG SUBDIVISION _ Wa)/js LOT # Z4
System Installer: � Registration #
Basement with plumbing: ❑ G rage *mber of Bedrooms 3
Type of Water Supply: El Community Q Public ❑ Well Distance from well feet
System Type: 4 z, >L"— � iZG 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 sysum 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:
II. Monitoring:
III. Maintenance:
IV. Operation:
V. Other.
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V�
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 ElPump ❑ Alarm ❑ H2OLine ❑ PWR Line
Following are the specifications for the sewa,Be disposal system on the above captioned proper�.r P �j{�
Type of system: ❑Conventional Cd Other 95el,; i7G for .i7tl ! Com►✓' Septic Tank_ v� gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches 3 of each ditch feet ditches 3 feet ditches 2— inches
French Drain Required: Linear feet / �,L�.�7.
Authorized State Ageq::: g C . Z&It �/C.A9�'i' / 1 Date
17-541458 (1) 17-5-41458 (2) 17-5-41458 (3) 17-5-41458 (4) 17-5-41458 (5)
17-5-41458(6) 17-5-41458(7) 17-5-41458(8) 17-5-41458(9) 17-5-41458(10)
LIMAN
17-541458 (11) 17-5-41458(12) 17-5-41458 (13) 17-5-41458(14) 17-5-41458(15)
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414
114
17-5-41458(16) 17-5-41458(17) 17-5-41458(18) 17-5-41458(19) 17-5-41458 (20)
17-5-41458(21) 17-5-41458(22) 17-541458(23) 17-5-41458(24) 17-5-41458(25)
Al
17-5-41458 (26) 17-5-41458 (27) 17-5-41458(28)