OPHTE0/ _5 ` 2,7 7-9 Harnett County Department of Public Health
PERMIT # S' Operation Permit - 22098
New Installation n Z Septic Tank Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION:
..~vo y,,~ St~4' 2n
Name: (owner) SUBDIVISION -LOT #
System Installer: Registration #
Basement with plumbing: ❑ Garage Number of Bedrooms 3
Type of Water Supply: ❑ Community Public ❑ Well Distanc fr m well feet
System Type: 5 L ~4 i `~'awc~ei~ tc TYPes V and VI Systems expire in 5 years.
(In accord,with_ Table V a) Owner must contact Health Department 6 months prior to expiration for permit renewal.
This system his been installed in compliance with applicable North
t'
Rules for Sewage Treatment and Disposal, and all conditions of the
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Permit and Construction Authorization
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PERMIT CONDITIONS:
1. 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, maigenance and reporting.
❑
D-Box
❑ Pump ❑ Alarm ❑
H20Line ❑ PWR Line
Following are the specifications for
the sewage disposal system on the above captioned property$
y-4
Type of system: ❑
Conventional
lid Other "o . & 4 3
Septic Tank: 90 gallons Pump Tank: gallons
Subsurface
No. of
exact length p y C
width of
depth of
Drainage Field
ditches
of each ditch J00 feet
ditches 3
feet ditches 5 inches
French Drain Required:
Linear feet
Authorized State A
nt ,
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Date
- Z l 2
ti :y
11-5-27783 (1)
11-5-27783 (2)
11-5-27783 (3)
11-5-27783 (4)
1-5-27783 (5)
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J,.•, ana
11-5-27783 (6)
11-5-27783 (7)
11-5-27783 (8)
11-5-27783 (9)
11-5-27783 (10)
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11-5-27783 (11)
11-5-27783 (12)
11-5-27783 (13)