OPNTE# 11-S—gMVI Harnett County Department of Public Health 24786
PERMIT # ZA 3" Operation Permit
New Installation 2'leptic Tank La Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOLATIONC e/M ,e/J
Name: (owner dAIIES O'D G UBDIVISION_—_LOT # —43�
System Installer: Registration #
Basement with plumbing: ❑ Garage ER*tuber of Bedrooms
Type of Water Suppl : ❑ Community L/J Public ❑ Well Distance from well feet
System Type: e�.� ..` ' aA 414A Types V and VI Systems expire in S years.
(In accordance with Table V a) /Owner must conta Department 6 months prior to expiration for permit renewal.
I. Performance: System shall perform in accordance with Rule .1961.
II. 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 ❑
Following are the specifications for the sewage disposal system on the above captioned property.
Type of system: ❑ Conventional ❑ Other
Subsurface No. ofexact length
Drainage Field ditches 2 of each ditch /24b feet
French Drain Required: Linear feet
M20Line ❑
Line
Septic Tank gallons Pump Tank: gallons
width of depth of
ditches feet ditchesinches
Authorized State Aft —;� C_ / �(.�r�lli . L� " ' Date I — Z —
17-5-40981(1)
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17-5-40981(2)
17-5-40981 (3)
17-5-40981 (6)
17-5-40981 (7)
m
17-540981 (8)
17-540981 (11) 17-5-40981 (12) 17-540981 (13)
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All
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17-540981 (4)
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y.
17-5-40981(9)
17-5-40981 (5)
17-540981 (10)