OPHTE#cam' S-19LION Harnett County Department of Public Health 23770
PERMIT # '�y530 Operation Permit
New Installation X Septic Tank Nitrification Line ❑ Repair ❑ Expansion
_ PROPERTY LOCATION: Naur. a brio✓&eo
Name: (owner) 'Fxak.%,4. 'w., c5 JR, SUBDIVISION rra•,m(zs 1`%__7 L-oti JOT #TQC
System Installer: osNm'S Registration #
Basement with plumbing: ❑ Garage Number of Bedrooms 136
Type of Water Supply: ❑ Community Public ❑ Well Distance from well feet
System Type: -- u er Types V and VI Systems expire in S years.
(In accordance with Table V a) Owner must contact Health Department 6 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 Permit and Construction Authoritation
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PERMIT CONDITIONS
I. Performance: System shall perform in accordance with Rule .1961.
ll. Monitoring: As required by Rule .1961.
III. Maintenance: As required by Rule .1961. Other.
Subsurface system operator required? Yes ❑ N CIA
If yes, see attached sheet for additional operation conditions, maintenance and reporting.
IV. Operation:
Other.
❑
D -Box ❑
Pump ❑
Alarm ❑ H2OLine ❑ PWR Line
Following are the
specifications for the sewage disposal system on the above captioned property.
Type of system:
ElConventional X Other
E Z Ft -by
Septic Tank: to O G gallons Pump Tank gallons
Subsurface
No. of
exact length
width of depth of
Drainage Field
ches _2 _
of each ditch �5 feet
ditches 3 feet ditches 3C inches
French Drain Reouired:
Linear feet
Authorized State Agent � �Wla`\\ Date If ls/ tS