OPHTE# I/,— s ` gOZOS3 Harnett County Department of Public Health 24780
PERMIT # Operation Permit
LSI New Installation Septic Tank Q Nitrification Line ❑ Repair ❑ Expansion
_ PROPERTY LOCATION: 5N4eto
Name: (owner) SUBDIVISION LOT # Z
System Installer. 14v2: --1A C L Fes-- Registration #
Basement with plumbing: ❑ Garage Number of Bedfoems 3
Type of Water Suppl . ❑ Community 9 Public EwWell Distance from well /y� feet
System Type: L�a/�P,i%�$���%7- b.IZT G Types V and VI Systems expire in S years.
(In accordance with Table V a) %— Owner Health Department 6 months prior to expiration for permit renewal.
This system has been installed in
North Carolina General Statutes, Rules for Senee Treasurers and
2S�
11314
and all conditions of the Imrrovement Permit
ala
I. Performance: System shall perform in accordance with Rule .1961. ([i <
11. Monitoring: As required by Rule .1961. VV ,.
111. Maintenance: As required by Rule .1961. Other.
Subsurface system operator required? Yes ❑ No ❑
If yes, see attached sheet for additional operation conditions, maintenance and reporting.
IV. Operation:
V. Other.
❑
of exact �
D -Box ❑
Pump ❑ Alarm
❑ H2OLine
❑
PWR Line
Following are the
specifications for the
sew dispo>�Iss�mn the xpove� captioned property.
ditches
of each ditch feet ditches feet
ditches to'—'24 D inches
Type of system:
❑Conventional
Other o m a.. 1L 5..5 �'
Septic Tank: U� 0 d gallons
Pump sank:
gallons
Subsurface
No.
length I
French Drain Required: Linear feet
Authorized State Agents--� 'V "'�"ry ' Date .W ���
width of
75 3
depth of
Drainage Field
ditches
of each ditch feet ditches feet
ditches to'—'24 D inches
French Drain Required: Linear feet
Authorized State Agents--� 'V "'�"ry ' Date .W ���
-1 ON 1: 9 IN1 1: 1 1: • 1 1: i
♦:Y
16-5-40208(11) 16-5-40208 (12) 165-40208(13) 16-5-40208(14) 16-5-40208(15)
mmadmium
16-540208 (16) 16-5-40208 (17) 16-540208 (18) 16-5-40208 (19) 16-540208 (20)