OPHTE# 1'7-S•U 10)W Harnett County Department of Public Health 24913
PERMIT # a5tlti 6 Operation Permit
New Installation 'X Septic Tank X Nitrification Line ❑ Repair ❑ Expansior
PROPERTY LOCATION: W,Lt L—vc,Ps Q�
Name: (owner) INC.- SUBDIVISION 5q-gvw. KyE'a. LOT # 6 )
System Installer. %.4y%w,N St{s,a Registration #
Basement with plumbing: ❑ Garage Nk Number of Bedrooms 3
Type of Water Supply: ❑ Community ;K Public ❑ 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 Catalina General Statutes, Rules for Sewage Treatment and Disposal, and all conditions of the Improvement Permit and Construction Authorization
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PERMIT CONDITIONS
I. Performance: System shall perform in accordance with Rule .1961.
It. Monitoring: As required by Rule .1961.
Ill. Maintenance: As required by Rule .1961. Other.
Subsurface system operator required? Yes ❑ Nox
If yes, see attached sheet for additional operation conditions, maintenance and reporting.
IV. Operation:
V. Other:
❑ D -Box ❑
❑ Alarm ❑
Following are the specifications for the sewage disposals stem on the above optioned property.
Type of system: ElConventional OtherZ FLo w Septic Tank
Subsurface No. of exact length width of
Drainage Field di es l of each ditch a"ar d feet ditches _
French Drain Required: Linear feet
H2O1-ine ❑
PWR Line
100 0 gallons Pump Tank: gallons
depth of
3 feet ditches UY ".SS inches
Authorized State Agent tZL-\-\S _ Date �1 II-\) I W