OP.►Harnett County Department of ,
PERMIT # Operation Permit
New Installation Septic Tank Nitrification Line ❑ Repair ❑ Expansior
PROPERTY LOCATION: 996--., ouP
Name: (ownerv) Vow t j C'. SUBDIVISION ME6 ;e7lAe_ LOT # r5�3
System Installer: F. -p g G ap— Registration #
Basement with plumbing: ❑ Garage ><Number of Bedrooms -3 x
Type of Water Supply: ❑ Communi >, Public ❑ Well Distance from well L ® b feet
System Type: CA. 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.
ims system has been installed in compliance with applicable North larolma beneral Statutes, Rules for Sewage Ireatment and Disposal, and all conditions of the Improvement Permit and Construction Authorization.
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rtRCnl LUNUIIlUN1:
I. Performance: System shall perform in accordance with Rule .1961.
II. Monitoring: As required by Rule .1961.
III. Maintenance: As required by Rule .1961. Other:
Subsurface system operator required? Yes ❑ No
If yes, see attached sheet for additional operation conditions, maintenance and reporting.
IV. Operation:
V. Other:
❑ D -Box ❑ Pump ❑ Alarm ❑ H2OLine ❑ PWR Line
Following are the specifications for the sewage disposal system on the abovf captioned property.
Type of system: ❑ Conventional Other CL4A%,( , lQ � Septic Tank: g. d gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches of each ditch t C feet ditches 3 feet ditches G inches
French Drain Required:Linear feet
Authorized State Agent ��� ate\ a g ;a3 Date 7 1 1
15-5- -S%I;L�)