OPMTE# N-- T-- 3 $3
PERMIT # 2 241
Name: (owner) U,.L,.e I
System Installer: T d
Basement with plumbing: ❑ Garage
Type of Water Supply: ❑ Community
System Type: 1�'.3,0 " 2
(In accordance with Ta e V a)
Harnett County Department of Public Health 23801
,Qperation Per '
New Installation 2r1eptic Tank 2 Nitrification Line ❑ Repair ❑ Expansior
PROPERTY LOCATION: /YJ Zzo
SUBDIVISION ll—�y LOT # 259
Registration #
This system ow been installed in compliance with applicable North
"j 3 p*,.A6 $ &67
I. Performance:
II. Monitoring:
Ill. Maintenance:
IV. Operation:
V. Other.
of Bedrooms
❑ Well
2b
e from well feet
Types V and VI Systems expire in S years.
must CaRA44Department 6 months prior to expiration for permit renewal.
for SA;ace Trea&ent and Disposal, and all conditions of the Imorovement Permit and
\51
G'
G s
7111;�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.
❑ D -Bax ❑ Pump ❑ Alarm ❑ 11201-ine ❑ PWR Line
Following are the specifications for the se—wa$" disposal system on the above captioned property.
Type of system: ❑ Conventional 13 OtherZEii%!1111Y-(j�'17S14*4— Septic Tank: Joop gallons Pump Tank: / d gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches of each ditch 300 feet ditches 3 feet ditches 1Z 41 � inches
French Drain Required: Linear feet
Authorized State Age4���� Date
—/7