OP RHTE# / S—� —316� 2/Z Harnett County Department of Public Health 23806
PERMIT #2`� J a0 erati� on Per Taut
New Installation C'I' Septic TankNitrification Line ❑ Repair ❑Expansion
T �vd%t^s ('fGCG� PROPERTY LOCATION:�z7a —7 ALeq In.p ,nq
Name: (owner) �l�i�D)� ?t6Cifee-T SUBDIVISION —� LOT #
System Installer. TNSdk Co-ovea-iA—s Registration #
Basement with plumbing: ❑ Garage f�N ber of Bedrooms 3
Type of Water Supply:
El LTJ Public ❑ Well Distance from well feet
System Type: Z3'4 tLAA.� sr—Z in $a Ta 6 — dre — Types V and VI Systems expire in S years.
(In accordance with Table V a) Owner m canto Health Department 6 months prior to expiration for permit renewal.
This system has been instilled in comoliamze with
PERMIT CONDITIONS:
I. Performance:
Il. Monitoring:
III. Maintenance:
IV. Operation:
V. Other.
I
for Sewage Treatment and DisposalAnd all conditions of
1 I` l�
y �a
System shall perform in acc--'---- will;
As required by Rule .1961. �L d� p7 N�.SJJar/a+r
As required by Rule .1961. Other:
Subsurface system operator required? Yes ❑ No ❑
If yes, see attached sheet for additional operation conditions, maintenance and reporting.
Permit and (onswztion Authorization.
i
❑ D -Box ❑ Pump ❑ Alarm ❑ H2O1-ine ❑ PWR Line
Following are the specifications for the sewwaa disposal system an the ,a-bove caRtioned property.
Type of system: ❑ Conventional I� Other Z�Z jL�%�[J �G't� Septic Tank: /d D d gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches / of each ditch 3 L () feet ditches 3 feet ditches zq inches
French Drain Required: Linear feet
Authorized State Ag22 .- 5�DateS—
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15-5-36832R (1)
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15-5-36832R (2)
15-5-36832R (3)
15-5-36832R (6)
15-5-36832R (7)
15-5-36832R (8)
F"M ,it
sem.
15-5-36832R (4)
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r-
15 -5-36832R (9)
Sa
15-5-36832R (5)
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yYY
15-5-36832R (10)
15-5-36832R (11)
15-5-36832R (16)
15-5-36832R (12)
15-5-36832R (17)
15-5-36832R (13)
15-5-36832R (14)
15-5-36832R (15)