OPNTE# 1�'�®"���9YHarnett County Department of Public Health 23599
PERMIT # Z$2 `� 2 Operation Permit
C'New Installation E?"�Septic Tank C' trification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION: ,t y-7 /7%/J9Gs U v /
Name: (owner) _S5 /-tZW4. i3-1) SUBDIVISION LOT # 27
System Installer: CJ psv4— j44 Registration #
Basement with plumbing: ❑ Garage 2' Number of Bedrooms Lf
Type of Water Supply: ❑ Community 2' Public ❑ Well Distance from well feet
System Type: ZtM 442-.- T G- a Types V and VI Systems expire in 5 years.
(In accordance with Table V a) Owner must cont t Health Department 6 months prior to expiration for permit renewal.
ims system nas peen installed m compliance with appucame north Larohna t,eneral xatutes, nines tot sewage treatment and
PERMIT CONDITIONS:
I. Performance:
11. Monitoring:
III. Maintenance:
IV. Operation:
V. Other:
I
and all conditions at the Improvement rermlt and Lonstruction Authorization.
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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.
❑
D -Box ❑
Pump ❑ Alarm ❑
H2O1-ine ❑ PWR Line
Following are the specifications for the sewage disposal system on the above captioned property.
Type of system:
❑ Conventional Other
2s"/o tl/�-b -ti — Septic Tank: f Z --"a
gallons Pump Tank: gallons
Subsurface
No. of
exact length width of
depth of
Drainage Field
ditches
of each ditch feet ditches
feet ditches 26 '� t inches
French Drain Required: Linear feet
Authorized State A Date
15-5-35494 (1)
15-5-35494 (2)
15-5-35494 (3)
15-5-35494 (4)
15-5-35494 (5)
15-5-35494 (6)
15-5-35494 (7)
15-5-35494 (8)
15-5-35494 (9)
15-5-35494 (11)
15-5-35494 (12)
15-5-35494 (13)
15-5-35494 (14)
15-5-35494 (10)