OPHTE# ,0 g~ _Z'- -5 Harnett County Department of Public Health
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PERMIT # ZfrD Operation Permit 22071
[2/New Installation Septic Tank I~ Nitrification Line ❑ Repair ❑ Expansion
PR RTY LOCATION: 5 1z1gc.f S
Name: (owner) ' C SUBD N SFO~ LOT # 3
System Installer: ter. Registratio #
Basement with plumbing: ❑ Garage E V public of Bedrooms 3
Type of Water Supply: ❑ Community L~" Public ❑ Well Di oee f om well feet
System Type: k?- '77,irzg 40 Types V and VI S tems expire in 5 years.
(In accordance with Table V a) Owne must contact Health Department onths prior to expiration for permit renewal.
This system has been installed in compliance with applicable Nort Carolina General Statutes, Rules for Sewage Treatment and Disposal, and all con ions of the Improvement Permit and Construction Authorization.
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PERMIT CONDITIONS:
1. Performance: System shall perform in accordance with Rule .1961.
II. 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-Box ❑ Pump ❑ Alarm ❑
Following are the specifications for the sews disposal system on the above captioned property.
Type of system: ❑ Conventional Other 75%t, ZArtytXW-,,_ 1 tas= & Septic Tank: 1,900
Subsurface No. of exact length width of
Drainage Field ditches of each ditch 60 feet ditches 3
H2OLine ❑
PWR Line
gallons Pump Tank: gallons
depth of
feet ditches inches
French Drain Required: Linear feet
Authorized State A Date LO - r'
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10-5-25583 (1) 10-5-25583 (2)
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-5-25583 (3) 10-5-25583 (4) 10-5-25583 (5)
77,773li"---WA 77
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10-5-25583 (6)
10-5-25583 (7)
10-5-25583 (8)
10-5-25583 (9)
10-5-25583 (10)