OPHTE# OS' s' 2,6 (-1.3 Harnett County Department of Public Health 2 0 4 3 8
PERMIT # Z ti 83a Operation Permit
[New Installation I Septic Tank ❑ Repair 2 Nitrification Line ❑ Expansion
PROPERTY LOCATION: S2 IS/o3 /Z6
Name: (owner) Z ' ✓/rd5e-1) SUBDIVISION y~y LOT # Z-
System Installer: rrrsz~ c,w-,~ a Registration #
Basement with plumbing: ❑ Garage [Zf Number of BBee °oms 3
Type of Water Supply: ❑ Community ❑ Public 5 Well Distance from well feet
System Type: 2S74'6 2tsp064-L" T 4k Zzr° 6 Z ~-y 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 Carolina General Statutes, Rules for Sewage Treatment and Disposal, and all conditions of the Improvement Permit and Construction Authorization.
'~S ~-n,...z~zs~-i 1 E►a
a
S
4--r>2~Ja
I
A H
r
~
Std p2i-~ ~
t~`
PERMIT CONDITIONS:
~~c•
1. Performance:
II. Monitoring:
Ill. Maintenance:
System shall perform in accordance with Rule .1961.
As required by Rule .1961.
As required by Rule .1961. Other.
IV. Operation:
V. Other.
Subsurface system operator required? Yes ❑ No ❑
If yes, see attached sheet for additional operation conditions, maintenance and reporting.
Following are the specifications for the sews disposal system on the above captioned property.
Type of system: ❑ Conventional I?r Other 25%IMI)oc lo~J S Septic Tank: 16 06 gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches t' of each ditch -21-_ feet ditches feet ditches 30- g inches
French Drain Required: Linear feet
Authorized State Ag Date 3 - L5-n9
» r
fC£ 3 ~ w~
r p
r; ~ ~ ~ i xl
I• ~ tY
s t e
j " "1 ~ i✓
"Lo
3F
y
f t` `r
e y`
k
A 3 ~t i~
R
iax'~ r •
y
t~ ~ " .r Pit 3
~ r.
C'.
x r
3l
a.
~k
3i s
J
4
t f
~a, fit; C
dx
.F
i
A~
W
Cnl
V'
~K 3
r
-:t b YYY~~~ ~r
- r R~-
Aw
, lei
3
i
L r f~ j
r
~
n
o
: