OPof Aarnett County Department
a. ' Public Health
'a •
PERMIT / ®peratl0ti_� /
d New Installation Septic Tank D/ Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION:
Name: (owner) (6n .r Z&2te, SUBDIVISION Z7;e-iff67-> LOT # Z
System Installer: ,r'-05ei( lu &2 s Registration #
Basement with plumbing: ❑ Garage 1 Nuder of Bedrooms 3
Type of Water Supply: ❑ Community LLall Public ❑ Well Distance from well feet
System Type: -1,57%s g T ypes V and VI Systems expire in 5 years.
(In accordance with Table V a) if Owne us c n Ith 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
rtKMI! LUNUMUNY
I. Performance:
II. Monitoring:
III. Maintenance:
IV. Operation:
V. Other:
(L —r ds
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 ❑ H2O1-ine ❑ PWR Line
Following are the specifications for the se—wase disposal system on the above captioned property.
Type of system: El Conventional LR' Other ZSY Septic Tank: /000 gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of r
Drainage Field ditches 3 of each ditch y b U feet ditches j feet ditches 1 ' . 3v inches
French Drain Required: Linear feet
Authorized State Aged -DO.— Z /1�L5, L�L � Date `r,t 9'"
15-5-35708 (1)
15-5-35708 (2)
15-5-35708 (3)
15-5-35708 (4)
15-5-35708 (5)
15-5-35708 (6)
15-5-35708 (11)
15-5-35708 (7)
15-5-35708 (8)
15-5-35708 (9)
15-5-35708 (10)