OPHTE# t, — 5 - 11)530 Harnett County Department of Public Health 24750
PERMIT # —).'i (016G Operation Permit
New Installation Septic Tank �K Nitrification Line ❑ Repair ❑ Expansior
PROPERTY LOCATION: 0Q.1V 6
Name: (owner) McXcir IiAO nES l^it- SUBDIVISION ar;ry,on LOT #
System Installer. Eo o. E Registration #
Basement with plumbing: ❑ Garage 'K Number of Bedrooms
Type of Water Supply: ❑ Community XPublic ❑ Well Distance from well feet
System Type: = > 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 system 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
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PERMIT CONDITIONS
1. Performance: System shall perform in accordance with Rule .1961.
Il. Monitoring: As required by Rule .1961.
III. 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.
❑ D -Box ❑ Pump ❑ Alarm ❑ H2O1-ine ❑ PWR Line
Following are the specifications for the sewage disposAI systee on111e above wptipned properly.
Type of system: ❑ Conventional '�§ ( Other ✓ 0-o 1 o C,Ng Fi6il L �f ,34 H 10 Septic Tank: ti00 o gallons Pump Tank: I a 00 gallons
Subsurface No. of exact length width of depth of
Drainage Field ditch _ of each ditch a1.1 -O feet ditches !' feet ditches t inches
French Drain Required: linear feet
Authorized State Agent VI.E3a5 Date
1�- 5-�1�53�