OP RH, iETT COUNTY HEALTH ••
ENVIRONMENTAL HEALTH SECTION
OPERATIONS PERMIT
Name: (owner)�j r r New Installation Septic Tank ❑ Repair
Property Location: SR# ErNitrification Line ❑ Expansion
Subdivision l ,L,r� Lot # Tax ID # Quadrant #
Contractor: = c �: l�K Registration #
Basement with Plumbing: ❑ Garage:
Water Supply: ❑ Well 2/public ❑ Community
Distance From Well: d--() ft.
Following are the specifications for the sewage disposal system on above captioned property.
Type of system: ❑ Conventional E3 Other L Z 2
Size of tank: Septic Tank: ,, t) gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches of each ditch ft. ditches ft. ditches Z in.
French Drain Required: Linear feet Date: 7 4-00s--
PERMIT NO. �QJ-qY Inspected by:
C 44� 1,.
--'---Harnett
0 U N T Y
NORTH CAROLINA
I -bw(� request that the
Harnett County Govemmant Cow-Prix
su Comalius Har"t Boulevard
Ufingto(k KC 27546
improvement Peimit # - () ��- — issued to me or (representative)
for a conventional or PUMP to conventional
septic system be changed to an innovative septic system
Chamber
P0edl
ly ne Aggregate Trench
4 & 4 !, .
I agree to provide ft Environmental Beafth Depatntnt with the origmal permit and the
authofimdion to consuuct before the ncw permit is issued. I also understand that this process
may take several woddag days.
strong roots - new growth
Date
ph: 910-893-7550
tax 9IU93-9429