OPHTE# fr_s - 0r Harnett County Department of Public Health
PERMIT # z ~ Operation Permit 22091
Qr New Installation Septic Tank D` Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION: zf-/--ZJ jt! kv f. 64
Name: (owner) ,~&1 45. ,tic.J/e,2_ SUBDIVISION LOT # Z,-t-_7
System Installer: , k Gliz, Registration #
Basement with plumbing: ❑ Garage R Number of Bedrooms 'S
Type of Water Supply: ❑ Community 0' Public ❑ Well Distance from well feet
System Type: 3°: d e *s' 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.
This system has been installed in compliance with applicable North Carolina General Statutes, Rules for Sewage Treatment and Disposal, and all conditions of the Improvement Permit and Construction Authorization.
c. t ~,e fT'3°
i
15
PERMIT CONDITIONS:
1. Performance: System shall perform in accordance with
11. Monitoring: As required by Rule .1961.
111. Maintenance: As required by Rule .1961. Other:
Subsurface system operator required? Y
If yes, see attached sheet for additio 1
1961.
❑No❑
operation conditions, maintenance
V
reports
AL
'Z 14
Operation:
IV
.
Other:
V
.
❑
D-Box ❑
Pump ❑
Alarm ❑ H20Line ❑ PWR Line
Following are the spe
cifications for the sewage disposal system on the above captioned property.
Type of system: ❑
Conventional 11
Other 9V& ~jcsu,? S ry~ _
Septic Tank: J' t gallons Pump Tank: gallons
Subsurface
Drainage Field
No. of
ditches
exact length
of each ditch f feet
width of depth of
ditches feet ditches . Z' t inches
French Drain Required: Linear feet
Authorized State Agehjt~~~- Date I - Z ~1
11-5-26681 (1) 11-5-26681 (2) 11-5-26681 (3) 11-5-26681 (4) 11-5-26681 (5)
u "
_ F
I a ~
11-5-26681 (6) 11-5-26681 (7) 11-5-26681 (8) 11-5-26681 (9) 11-5-26681 (10)
'i alt ps
11-5-26681 (11) 11-5-26681 (12) 11-5-26681 (13) 11-5-26681 (14) 11-5-26681 (15)
11-5-26681 (16) 11-5-26681 (17)