HomeMy WebLinkAboutOP R'ITE# 13-5— -Z� CL Harnett County Department of Public Health 23387
PERMIT peration Permit
New Installation X. Septic TanC'g Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION: Co ,
Name: (owner) SUBDIVISION LOT #
System Installer: C>\, 0 5 In t4 Registration #
Basement with plumbing: ❑ Garage"b< Number of Bedrooms 3
Type of Water Supply: ❑ Community ❑ Public X Well Distance from well t b C"J feet
System Type: Types V and VI Systems expire in 5 years.
(In accordance with Table V a) Owner must contact Health Department 6 months prior to expiration for permit renewal.
Ims system has been installed in compliance with applicable North Larolina beneral Statutes, Rules for Sewage Ireatment and Disposal, and all conditions of the Improvement Permit and Construction Authorization.
rtnrul Lurvu111UNN:
I. 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 ❑ N94
If yes, see attached sheet for additional operation conditions, maintenance and reporting.
IV. Operation:
V. Other:
❑ D -Box ❑ Pump ❑
Following are the specifications for the sewage disposal system on the above captioned property.
Type of system: ❑ Conventional X Other ff--2— 1FL0w
Subsurface No. of exact length
Drainage Field ditches — of each ditch ! (50 feet
French Drain Reauired: *-* \' Linear feet
Alarm ❑
H2OLine ❑
y.% -11v
Septic Tank: roar gallons Pump Tank:
width of depth of
ditches 3 feet ditches
Authorized State Agent_ __ NAti Date
PWR Line
gallons
inches
I 3 - 5-30-1 s -6e-.