OP RHTE #13 -s - SZE -5VZ Harnett County Department of Public Health 23332
PERMIT # � %0'7 ��eration Per /
New Installation Septic Tank Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION:A,/yYo ,�
Name: (owner) �'��3e�s SUBDIVISION sties / /s 4f&&& Ap, LOT # Z6
System Installer: Registration #
Basement with plumbing: ❑ ara a Z umber f Bedrooms V_
Type of Water Supply: ❑ Community Id Public ❑ Well Distance from well feet
System Type: />a tM d� PVZ- yjws I Systems expire in 5 years.
(In accordance with Table V a) Owner must contac ealth en 6 mo prior to expiration for permit renewal.
This system has been installed in compliance with applicable North Carolina Generall Statutes, Rulesofo Sewage Trea ent an and con i mprovement Permit and Construction Authori tion.
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PERMIT CONDITIONS:
I. Performance: System al m in accordance with Rule .1961.
II. Monitoring: As require y Rule 1961. 11
III. Maintenance: As required b Rule . 61. Other:
Subsurface syste opera r required? Yes ❑ No ❑
If yes, see attac d shee for additional operation conditions, maintenance and rep Irting.
IV. Operation:
V. Other:
❑ D -Box ❑ ❑ Alarm ❑ 1-12O1-ine ❑ PWR Line
Following are the specifications for the sewage disposal syst on the ab ve captioned property.
Type of system: ❑ Conventional LAY Other 2S90 rZ1.0oLre,ca--�— Septic Tank: a I-* gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches of each ditch 0 q feet ditches feet ditches t 8 inches
French Drain Required: Linear feet
Authorized State Ag Date
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13- 5- 3255OR (2)
13- 5- 3255OR (3)
13- 5- 3255OR (4)
13- 5- 3255OR (5)
13- 5- 3255OR (6)
13- 5- 3255OR (1)
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