OP%10y" 7//7
HTE# /S- 5-3-72/0 Harnett County Department of Public Health 23899
PERMIT #z � o O ereration Pe�mit /
5 New Installation Lid Septic Tank C2" Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION:,3r15e1f At7Ar -IS
Name: (owner)l ��s�, G carr. SUBDIVISION LOT # I
System Installer: / Registration #
Basement with plumbing: ❑ Garage 0 Number of Bedrooms
Type of Water Supply: ❑ Community d Public ❑ Well Distance from well Cid feet
System Type: Z5116t/ .G �ZCG V and-Whystems expire in S years.
(In accordance with Table V a) Owner musk contact)[) ealt dat 6 months prior to expiration for permit renewal.
I y`' iIt
has been installed in fURIDIIN a with aoolicable North Carolina CAmral Statutes, Rules for
I. Performance:
ll. 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.
Permit and Construction Authorization.
❑
D -Box ❑
Pump ❑
Alarm ❑ H2OLine ❑ PWR Line
Following are the
specifications for the sewwaaRe disposal system; the above captioned property.
Type of system:
❑ Conventional L1 Other %Sula'f7�7t
Cf % 0`?1
Septic Tank: 106 a gallons Pump Tank: gallons
Subsurface
No. of
exact length
width of depth of (k0—> 19
Drainage Field
ditches
of each ditch I O feet
�3_��
ditches 3 feet ditches � inches
French Drain Required: Linear feet
Authorized State ZI/�---, Date
15-5-37210 (1)
15-5-37210 (2)
15-5-37210 (3)
15-5-37210 (4)
15-5-37210 (5)
15-5-37210 (6)
15-5-37210 (11)
15-5-37210 (7)
'�T Y
15-5-37210 (12)
155-37210 (8)
15-5-37210 (13)
15-5-37210 (9)
a'.
15-5-37210 (14)
15-5-37210 (10)