OPHTE# 08-.5-Z093~ Harnett County Department of Public Health 2 0 4 3 0
PERMIT # a y eyo Operation - Permit
New Installation I Septic Tank ❑ Repair Nitrification Line ❑ Expansion
Name: (owner) A,xt/ PROPERTY LOCATION: <~e- u,j4&.j'r "b
SUBDIVISION Gtilr/lrr,. z c G e -7 LOT # Z
System Installer: /c-,~a~ l~P Registration #
Basement with plumbing: ❑ Garage ❑ Number of Bedrooms 3
Type of Water Supply: ❑ Community F11 Public ❑ Well Distance from well feet
System Type: Z5%U6ro ;An.Z),) S7v!Ad,,, ,t A=7' G iC-Z~ 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.
inn spuem nas ueen msianea in compuance wttn appu(aowe north larouna beneral Statutes, Rules for kwage Treatment and Disposal, and all conditions of the Improvement Permit and fonstrucoon Authorization.
~v 5 /~'6YZ64'1'o F vLa 2 ifs r2~lc~-ii►`-~
z 3-~9
r2l
xwo r44 45-6 orsrt-
~ JL
1 t b 40'
q,o yo' 5-z-,o6
J
K-e
ID~► `
3tZ 15-S1 zl-)
rEnrni wnvnwna:
1. 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 ❑ No ❑
If yes, see attached sheet for additional operation conditions, maintenance and reporting.
IV. Operation:
V. Other
following are the specifications for the se disposal system on the above captioned property.
Type of system: ❑ Conventional Other 157- AXI)yttLuyJS,.5Septic Tank: l00 0 gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches Ll of each ditch -S feet ditches 3 feet ditches 2q IS inches
French Drain Required: Linear feet
Authorized State Fit
Date
~ ~ ~ t t~r ~ 'L 9~ s
ry rA 4 ~.r
~ i
;a i f ~p~ t
l:>. ,T ~F ate. t ,k /y
i~
'Ape f,
"s
~ b
A
Ift
'All
r
fit
~ s+k r ~ r k
E
AV
ar ' _ r
sF" '
b
l V
i
i Z
U
N
.-J
k