OP RH T E # �-z c, arnett County Department of Public Health 23180
Operation
PERMIT # ZC��1C.9 L Per it ,o
New Installation ® Septic Tank Q' Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION: >72 e a
Name: (owner) SUBDIVISION LOT # Z—.
System Installer: Re,, 'icy Registration #
Basement with plumbing: ❑ Garage E N mber of Bedrooms
Type of Water Supply: El Community L�J' Public ❑ Well Distance from well feet
System Type: 7-5% - -Fk? J76Types V and VI Systems expire in 5 years.
(In accordance with Table V a) Owner TV contact Health Department 6 months prior to expiration for permit renewal.
This system h been installed m compliance with applicable North Carolina General Statutes, Rules for Sewage Treatment and Disposal, and all conditions of the Improvement Permit and Construc'on Authorization.
French Drain Required: Linear feet
Authorized State Date