OP RHTE#~~.oS~SR Harnett County Department of Public Health 2 0 9 8 0
PERMIT # 55500Operation Permit
New Installation c=Septic Tank ❑ Repa~-'j~rification Line ❑ Expansion
~PROPERTY LOCATION: Name: owner /6I27CS SUBDIVISION d S~t RC LOT #
System Installer: Registration #
Basement with plumbing: ❑ Garage `Z Number of Bedrooms _-3
Type of Water Supp~ ❑ Community V Public ❑ Well Distance from well Z-22 feet
System Type: C„(.~ L( 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 p6lit 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 Improvemeye"I(ermit and Construction Authorization.
pg) r py, ,/7-
Or z ,1" X >1 "j- 9
i
PERMIT CONDITIONS:
1. Performance: System shall perform in accordance with Rule .1961.
ll. 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 operatio e~
IV. Operation:
V. Other:
i
maintenance and reporting.
Following are the specifications for the se age disposal tem on the bove captioned property.
Type of system: ❑ Conventional I -p- Other u s Septic Tank: 1200 gallons Pump Tank: gallons
Subsurface No. of VVVV exact length width of depth of
Drainage Field ditches _ of each ditch ~ feet ditches _ 3 feet ditches inches
French Drain Required: Linear feet
Authorized State Agent I , \ 4~ ~ JL) Date IDI - ~ - I
z
J
I
p
f'
r
1 ff ~-tip
e ~
l
~pyQg- - _ 5 l - ~ -
'
g
.S
a`+fM319
fig
q'1 x r y
s
i
k
.~i ~ ~