OPHTE# lE—S— `��675 Harnett County Department of Public Health 24820
PERMIT # -2') 0 eration Permit
CeKNew Installation Tank 21 Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION: su vo3 6weI T2�
Name: (owner) FtzaS LL -<-SUBDIVISION web g r',o-�. LOT # e.1
System Installer. Ab Registration #
Basement with plumbing: ❑ Garage Number of Bedrooms 3
Type of Water Supply: ❑ Community 2"'Public ❑ Well Distance from well feet
System Type: 7S'3a 1?f/tic;t,7 4�— 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 Nonh Carolina General f utes, Rules for Sewage Tmammnt-and Disposal, and all conditions of the Improvemem Permit and Construction Authorization.
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PERMIT CONDITIONS
I. Performance:
11. Monitoring:
III. Maintenance:
IV. Operation:
V. Other.
System shall perform in accordance with Rule .1961.
As required by Rule .1961.
As required by Rule .1961. Other.
Subsurface system operator required? Yes ❑ No ❑
If yes, see attached sheet for additional operation conditions, maintenance and reporting.
❑ D -Box ❑ Pump ❑ Alarm ❑ H2O1-ine ❑ PWR Line
Following are the specifications for the sewa a disposal syssgm on the a ore captioned property.
Type of system: ElConventional 70ther L Septic Tank:o/ 0 D gallons Pump Tank gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches of each ditch 4�0 feet ditches feet ditches 7('L4 inches
French Drain Required: Linear feet
Authorized State Agen( \LGA - > ` -- 'f "T-3 Date (— — 13 — 1 6
18-543075 (1) 18-5-43075 (2) 18-5-43075 (3) 18-5-43075 (4) 18-5-43075 (5)
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18-5-43075 (6) 18-5-43075 (7) 18-5-43075 (8) 18-543075 (9) 18-5-43075(10)
18-543075 (11) 18-5-43075 (12) 18-543075 (13) 18-543075 (14) 18-543075 (15)
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18-543075 (16) 18-5-43075 (17) 18-543075 (18) 18-543075 (19) 18-543075 (20)