OPHTE# /5-- 5-37q Harnett County Department of Public Health 23891
PERMIT # Z ele(S83 Operation Permit —/
Fr New Installation Septic Tank 2 Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION
Name: (owner) , � / ,,j F .v .� SUBDIVISION t,)/FAe- 7'o.=.Jt LOT # Z
System Installer: Registration #
Basement with plumbing: ❑ GarageCumber of Bedrooms 3
Type of Water Supply: El Community Ld Public ❑ Well Distance from well feet
System Type: Z5u�Vc-Tac — and VI Systems expire in S years.
(In accordance with Table V a) Owner mustiC�lealtt 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 Lonstmtlion wtnoneanon.
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PERMIT CONDITIONS:
I. Performance:
11. Monitoring:
III. Maintenance:
IV. Operation:
V. Other:
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 ❑ H2O1-ine ❑ PWR Line
Following are the specifications for the sewag a disposal system on the above captioned property.
Type of system: ElI7 Conventional Other 150/ l/ >v craok!s %— Septic Tank: I O o O gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches of each ditch feet ditches 3 feet ditches Zq inches
French Drain Required: linear feet /
Authorized State Agent�`/� _ Z %3.d -,j AO -,n_.`4 Date I ' Z - I (y
15-5-36379 (1) 15-5-36379 (2)
� _: - �✓ tit'.
15-5-36379 (6) 15-5-36379 (7)
15-5-36379 (11) 15-5-36379 (12)
15-5-36379 (3)
15-5-36379 (4)
15-5-36379 (5)
15-5-36379 (8)
15-5-36379 (9)
15-5-36379 (10)