Loading...
OPHTEo~ Harnett County Department of Public Health 21 2 3 5 PERMIT # DJZ1s-3 Operation Permit New Installation X Septic Tank ❑ Repair b~ Nitrification Line ❑ Expansion PROPERTY LOCATION: JAC s.v,,,~, Name: (owner) Q;wi o `5~5s~,K SoaoA~1 SUBDIVISION Ogt,g C . ~oNO~.rt LOT # 2. System Installer: ~~n,r.,.t ~F1tJEy Registration # Basement with plumbing: ❑ Garage ~I Number of Bedrooms Type of Water Supply: ❑ Community Public ❑ Well Distance from ell feet System Type: Zs ~ 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. This 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 ~PesS FE.at~ P p~2~-•a~o i P'o^P s ~r &A V0 1*4, C> h r cnrn i wnun ivM. 1. Performance: II. 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 opera ton conditions, maintenance and reporting. Following are the specifications for the sewage disposal s stem on the above captioned property. Type of system: ❑ Conventional Other Z Septic Tank: to O b gallons Pump Tank: 10 © V gallons Subsurface No. of exact length width of depth of Drainage field ditches -,,of each ditch L-1 d feet ditches 3 feet ditches inches French Drain Reauiredi~- Authorized State Agent -"Z' czt=t~5 Date 1 I n P u ~ Z fy e ~F ~GP'Al 4 S r ~ ti rr xr f,: k 4i Ilk,. + ~ r ~d M l . u e x