OPITE# 114 Harnett County Department of Public Health 2 3 2 9 A
PERMIT # 1a Operation Permit
New Installation �K Septic Tank Nitrification Line El Repair El Expansion
PROPERTY LOCATION: 1 y),nEJV owe "3g`S(Zsa„ E) ez®
Name: (owner) v'i ar^E-5 LLC. SUBDIVISION VIP, v4,. LOT # 91
System Installer: 5Ze`5 � G-- Registration #
Basement with plumbing: ❑ Garage Number of Bedrooms
Type of Water Supply: ❑ Community C Public ❑ Well Distance from well feet
System Type: 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.
PERMIT CONDITIONS:
I. 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 operation conditions, maintenance and reporting.
❑ D -Box ❑ Pump ❑ Alarm ❑ H2OLine ❑
Following are the specifications for the sewage disposal system on the above captioned property.
Type of system: El Conventional Other G---,;, — W Septic Tank: gallons Pump Tank:
Subsurface N . exact length width of depth of
Drainage Field ditches of each ditch �® feet ditches feet ditches
French Drain Reouired: Lin
Authorized State Agent Date
PWR Line
gallons
inches
14- S 330`76