OPHTE# II -5 -419 -q Harnett County Department of Public Health 24160
PERMIT # 51 R05 bmtion Perm' ��
few Installation Septic Tank N}S itrification Line El Repair 1:1 Expansion
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PROPERTY LOCATION: -x 4r3 A eri 0�-1G1bc. C c vkt7W,4e- " 5rc )4 �J
Name: (owner)l {�s5 Akan Jnr SUBDIVISION A �1� P cs LOT #
System Installer: b Registration #
Basement with plumbing: ❑ Garage �u�mber rooms
Type of Water Supply: ❑ CommunityuL� 'Ric LJ Well Distance from well feet
System Type: S.s , Types V and VI Systems expire in S years.
(In accordance with Table V a) Owne ust contact Health Department 6 months prior to expiration for permit renewal.
lhn system has been maolled in Compliance with applioble 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
I. Performance: System shall perform in accordance with Rule .1961.
11. 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:
Other.
❑ D -Box ❑ Pump ❑ Alarm ❑ H2OLine ❑ PWR Line
Following are the specifications for the sewage ddisp9�al system on the above captioned too erty.
Type of system: ❑ Conventional I7!her x �lr; �! Septic Tank: 1 2S6 gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches 3 of each ditch t UO feet ditches 3 feet ditches y$ a0 inches
french Drain Required: Linear feet
Authorized State Agent Date 0 a I as 1 ;;cj�