OP RHTE#J5�L 34e Harnett County Department of Public Health 23799
PERMIT# 2253S2 Operation PermJt
LSF New Installation Septic Tankitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION.-W/Y ? 14f.,Zs 6/4✓3 d66
Name: (owner)-1_AS--=a *-5. -dQ4 e_ /-A/Ltsl(rnn_SUBDIVISION .7-14- LOT # S
System Installer:Registration #
Basement with plumbing: 1:1Garage Z/Number of Bedrooms
Type of Water pply. ❑ Community 17 Public ❑ Well Distance from well feet
System Type:ur,�,�-v Z� Flo �_Sasds¢.a_ /4r�.71•T V end VI Systems expire in 5 years.
(In accordance with Ta le V a) Owner must cont artment mon prior to expiration for permit renewal.
This system has been installed in compliance with applicable North Cjrolina General
PERMIT CONDITIONS
I. Performance:
Il. Monitoring:
III. Maintenance:
IV. Operation:
V. Other.
7W- ,d
(s,
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.
and Construction Authorization.
❑ D -Box
❑ Pump ❑
Alarm ❑ M20Line
❑ PWR Line
Following are the specifications for
the sewa disposal system on the above
captioned property.
Type of system: ❑ Conventional
( Other /fid. _ is �':.NL/tf
Zs`Li.
Septic Tank: /000 gallons
Pump Tank: �'ejD � gallons
Subsurface No. of
exact
width of
depth of
Drainage Field ditches
of each ditch
�d feet
ditches 3 feet
ditches 60'—�Za inches
French Drain Required:
Linear feet
Authorized State een��� 7 C• Date /0 _<' -
W.
15-5-35683R (1) 15-5-35683R (2) 15-5-35683R (3) 15-5-35683R (4) 15-5-35683R (5)
15-5-35683R (6) 15-5-35683R (7) 15-5-35683R (8) 15-5-35683R (9) 15-5-35683R (10)
15-5-35683R (11) 15-5-35683R (12) 15-5-35683R (13) 15-5-35683R (14) 15-5-35683R (15)
i^!1'
15-5-35683R (16) 15-5-35683R (17) 15-5-35683R (18) 15-5-35683R (19) 15-5-35683R (20)
15-5-35683R (21) 15-5-35683R (22) 15-5-35683R (23) 15-5-35683R (24) 15-5-35683R (25)
15-5-35683R (26)