OP R5-�{c�ut Harnett County Department of Public Health 24976
PERMIT # 29935 Aeration Permg---
Eid New Installation Septic Tank .I� �Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LKATION: 3ISS cJ C a 10 N.
Name: (owner) 4e'42 0 SUBDIVISION LOT #
System Installer: CA At b, Registration #
Basement with plumbing: ❑ Garage E N�of Bedrooms
Type of Water Supply: El Coma unity C? ublic ❑ Well Distance from well 4\/4 feet
System Type: S"o '(Lr- b c I t Types V and VI Systems expire in S years.
(In accordance with Table V a) 0 must contact Health Department 6 months prior to expiration for permit renewal.
This system has been installed in
with amlicable North Carolina General
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and all conditions of the Improvement Permit and Construction Authorization.
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:
V. Other.
❑ D -Bax ❑ Pump ❑ Alarm ❑ H20Line ❑ PWR Line
Following are the specifications for the sewage oust system on thea ave captiooned� rty.
Type of system: El Conventional �� JIF�t Septic Tank IQaf) gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches Ll'" of each ditch feet ditches - feet ditches inches
French Drain Required: Linear feet
Authorized State Agent Date I �� ac 18
iy. 40.1# U-
1
AAIW* 14,44 1