OPHTE# nYS 4 -AO-)- Harnett County Department of Public Health 25053
PERMIT #���ir� Operation Permit
New Installation X Septic Tank X Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION:—\4%,-L. Lvposs
Name: (owner) V6,t c o w l N C. SUBDIVISION S,.+FLns resE2 LOT # 51
System Installer. Nes SF.e-s,e Registration #
Basement with plumbing: ❑ Garage Number of Bedrooms 3
Type of Water Supply: ❑ Community 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.
[his system has been installed in compliance with applicable Norah Carolina Genenl Statutes. Rules for Sewage Treatment and Dispou4 ad all conditions of the Improvement Permit and (onswaiun Authorization,
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PERMIT CONDITIONS:
Performance: System shall perform in accordance with Rule .1961
Monitoring: As required by Rule .1961.
Maintenance: As required by Rule .1961. Other.
Subsurface system operator required? Yes ❑ Nov
If yes, see attached sheet for additional operation conditions, maintenance and reporting.
IV. Operation:
V. Other.
❑ D -Box ❑ Pump ❑ Alarm ❑ H2OLine ❑ PWR Line
Following are the specifications for the sewage disposal system on the abovgg boneQ property.
Type of system: ❑ Conventional )K Other l� �Qa 9R ltd y� Septic Tank 1000 gallons Pump Tank
Subsurface No. of gallons
exact length width of depth of
Drainage Field --dstt_es 1 of each ditch feet ditches 3 feet ditches 3J� inches
French Drain Required: Linear feet
Authorized State
ei�—' `'J Date 413 01 1-%
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