OPHTE# Iz{-S-ism Harnett County Department of Public Health 23812
PERMIT # 25201 w 'OperationPerPermitId- New installation
Septic Tank Q""Nitrification Line ❑ Repair ❑ Expansior
PROPERTY LOCATION:f Pii 3/Zrtr !Z6
Name: (owner) -'Isd Lel(-,,- _ SUBDIVISION Zar,,l LOT # 3__
System Installer: dw Registration #
Basement with plumbing: ❑ Garage Number of Bedrooms t{
Type of Water Supply: ❑ Community Public ❑ Well Distance from well feet
System Type: �% T y es V S ste s expire in S years.
(In accordance with Table V a) wner must act ealth qe a m nt 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 Yemat and Construction Authorization
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PERMIT CONDITIONS
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 -Boz ❑ Pump ❑ Alarm ❑
H2O1-ine ❑
PWR Line
Following are the specifications for the sewage disposalsystem on the above captioned property.
Type of system: ❑ Conventional C�' OtherIS�/eRpl�tltltdL Septic Tank: I -1,L) D gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of
Drainage field ditches f of each ditch 3f. O feet ditches I feet ditches ZZ inches
French Drain Required: Linear feet /
Authorized State A2 tt 'a-._-� � lo,4-�.,.t(� // Date
14-5-35006 (1)
14-5-35006 (2)
14-5-35006 (3)
i . ?)
14-5-35006 (4)
14-5-35006 (6)
14-5-35006 (7)
14-5-35006 (8)
14-5-35006 (9)
1
14-5-35006 (12)
14-5-35006 (13)
r:
14-5-35006 (16)
14-5-35006 (17) 14-5-35006 (18)
14-5-35006 (5)
14-5-35006 (10)
1 �
14-5-35006(15)