OPHTE# )N S ULl3)� Harnett County Department of Public Health 25085
PERMIT # Operation Permit 0/,g.Ea.o,w'srD PR
❑ New Installation ❑ Septic Tank )� Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION: 91M c¢,&ss Dz
Name: (owner) M�eo++NtLLs iS�sS� SYsSEra� SUBDIVISION 9vwii j%aclusc2bAL Ca2J+ LOT # L
System Installer.. 1-1-4 — Registration #
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Basement with plumbing: Garage 350 U
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.
This system has been installed in compliance with applicable North Carolina General Statures, Rules for Sewage Treatment and Disposal, and all conditions of the Improvement Permit and construction Authorintion
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PERMIT CONDITIONS
1. Performance:
System shall perform in accordance with Rule .1961.
Il. 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. Y Yln e, -4«l6 G csct�tV
❑ D -Box ❑ Pump ❑ Alarm ❑ H2OLine ❑ PAIR Line
Following are the specifications for the sewage disposal system on the above captioned property.
Type of system: ❑ Conventional ❑ Other F—ZFs-crc Septic Tank 64e'61%^44 gallons Pump Tank 5-MA15014C gallons
Subsurface No, of exact length width of depth of
Drainage Field di of each ditch 7 S feet ditches 3 feet ditches a4 inches
French Drain Reauired: Linear feet
Authorized State Agent `N� , Qf3a-5 Date P-