OPHTE#I Harnett County Department of Public Health 24813
PERMIT # ci N 9 -7 / Operation Permit /NitHificathorl,
New Installation Septic Tank Line ❑ Repair ❑ Expansion
PROPERTY LOCATION15 Oct r;!6
Name: (owner) UBDIVISION LOT# 12
System Installer: Akiiii:Q-, T Registration #
Basement with plumbing: 13 Garage � umber of Bedrooms 7
Type of Water Supply: ❑ Communi ZPu�E Well Distance from well feet
System Type: GltlLPu/N,�r 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 instilled in compliance with applicable North Carolina
iry14{tED lAW,
for Sewage Treatment and
G 61
and all conditions of the
PERMIT CONDITIONS: 1
1. Performance: System shall perform in accordance with Rule .1961. t1
It. Monitoring: As required by Rule .1961. V
111. 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 ms, ❑ Pump ❑
Following are the spe ' cations for the sewage disposal system on the above captioned property.
Type of system: Conventional ❑ Other
Subsurface No. of exact length
Drainage Field ditches of each ditch S Zi feet
(e6
Permit and Construction Authorisation.
Alarm ❑ H2OLine ❑ PWR Line
_ Septic Tank:gallons Pump Tank gallons
width ofdepth of
ditches feet ditches . Z(0 inches
French Drain Required: Linear feet
Authorized State Ag(L&a t5-
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17-5-41521(16) 17-5-41521(17) 17-5-41521(18) 17-5-41521(19) 17-5-41521(20)