OPHTE# lT—* = 3,�0-Z Harnett County Department of Public Health 23880
PERMIT # zesz eratlOn Permit
L�New -Installation LCSepeptic Tank ETINitrification Line ❑ Repair ❑Expansion
PROPERTY LOCATION:3C../7u 3 /ls-2A4�// CI��Ct0c
Name: (owner) C'/Xff fes+ SUBDIVISION ot4nic,_f LOT # 3
System Installer. Registration #
Basement with plumbing: ❑ Garage 0 lhsmber of Bedrooms 3 _
Type of Water Supply: ❑ Community Public ❑ Well Distance h in well f
System Type: si= SG 6 Types V and VI S ste s expire in 5 years.
(In accordance with Table V a) Owner cast contact Health onths prior to expiration for permit renewal.
This system has been installed in comoliance with amlicable North Carolina General Statutes, R es for Sewa¢e Treatment and isposal, and 111 con tions of the Impmvemem Permit and Construction Authorization.
I. Performance:
ll. Monitoring:
III. Maintenance:
IV. Operation:
V. Other:
SN
I
Tr
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f
St -/-7o3 R&aw-"fi cw-X-t-'�
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 ❑ H20Line ❑ PWR Line
Following are the
specifications for
the sewa disposal system on the above captioned property.
Type of system:
❑ Conventional
f Other 15%17*0P 64—kr.—
Septic Tank l o • D gallons Pump Tank gallons
Subsurface
No. of
exact length
width of depth of
Drainage Field
ditches
Z- of each ditch /7D feet
ditches 3 feet ditches 19" inches
French Drain Reauired:
Linear feet
Authorized State AnL__�---��
15-5-37202 (1)
15-5-37202 (2)
15-5-37202 (3)
15-5-37202 (4)
15-5-37202 (5)
15-5-37202 (6)
15-5-37202 (7)
15-5-37202(8)
15-5-37202 (11)
15-5-37202 (16)
15-5-37202 (12)
15-5-37202 (13)
15-5-37202 (9)
15-5-37202 (14)
15-5-37202 (10)
15-5-37202 (15)