OPHTE #/� =�'1320-2 Harnett County Department of Public Health 23356
PERMIT # Z786t ep ration Per t
New Installation ff Septic Tank Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION: �YV� �� � .eo
Name: (owner) /�Ct.�6,e,- Ta- SUBDIVISION �/� LOT # Zz!
System Installer: -=J Registration #
Basement with plumbing: ❑ Garage umber of Bedrooms .3
Type of Water Supply: El Community Public ❑ Well Distance from well feet
System Type: 2S-% r— 02 tA, Types V and VI Systems expire in 5 years.
(In accordance with Table V a) Owner must co tact Health Department 6 months prior to expiration for permit renewal.
This system has been installed in compliance with applicable North CarolinalGeneral Statutes, for Sewage Treatment and Disposal, and all conditions b the
PERMIT CONDITIONS:
I. Performance:
II. Monitoring:
III. Maintenance:
IV. Operation:
V. Other:
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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.
Permit and Construction Authorization.
❑
D -Box ❑
Pump ❑ Alarm
❑ H2OLine ❑ PWR Line
Following are the specifications for the seew3ge disposal system on the above captioned property.
Type of system:
❑ Conventional E2f Other
7S% r? "E-bv r1,n= A,?,—
Septic Tank: /Uy b gallons Pump Tank: gallons
Subsurface
Drainage Field
No. of
ditches
exact length
of each ditch ° ° feet
width of depth of
ditches 3 feet ditches
�— inches
French Drain Required: Linear feet
Authorized State Agent �✓ Date
14 -5- 33307(2)
14 -5 -33307 (3)
14 -5 -33307 (4)
14 -5 -33307 (5)
14 -5- 33307(6)
14 -5 -33307 (7)
14 -5 -33307 (1)
14 -5 -33307 (8)
14 -5 -33307 (9)
14 -5- 33307(10)
14 -5- 33307(11)