OPHTE#; s 15- 3�32L, Harnett County Department of Public Health 23901
PERMIT # Z 857 c> 1 Operation Pe mit
LI
New Installation c Tank dNitrification Line El Repair El Expansion
_ PROPERTY LOCATION:hr IW3 /'l�,/ ralA,db
Name: (owner) SUBDIVISION LOT #
System Installer. 477AAfrK — Registration # f 1-7 -7
Basement with plumbing. ❑ Garage Number of Bedrooms y
Type of Water Suppl,yy: [ICommunity EJ Public ❑ Well Distance from well feet
System Type: tZ66 ° 5 r cd+Va.._ EEL (g Gz -r�Apes V and VI Systems expire in S years.
(In accordance with Table V a) Owner must contact R2alth 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 Authorization
❑ D -Box ❑ Pump ❑ Alarm ❑ H2OLine ❑ PWR Line
Following are the specifications for the sew ge disposal system on the above captioned property.
Type of system: ❑ Conventional Other 7Septic Tank: gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches Li of each ditch 100 feet ditches 3 feet ditches L 4 inches
French Drain Required: Linear feet
� e+5
Authorized State Ag&L/�� L— Z�2t Date
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I
I
I
LL
PERMIT (OND IONS:
I. Perform nce:
System shall perform in accordance with Rule .1961.
If. Monitor g:
As required by Rule .1961.
III. Mainten nce:
As required by Rule .1961. Other:
Subsurface system operator required? Yes ❑ No ❑
If yes, see attached sheet for additional operation conditions, maintenance and
reportin .
IV. Operation:—`---
—
a's�
—
V. Other.
❑ D -Box ❑ Pump ❑ Alarm ❑ H2OLine ❑ PWR Line
Following are the specifications for the sew ge disposal system on the above captioned property.
Type of system: ❑ Conventional Other 7Septic Tank: gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches Li of each ditch 100 feet ditches 3 feet ditches L 4 inches
French Drain Required: Linear feet
� e+5
Authorized State Ag&L/�� L— Z�2t Date
IL
15-5-37326 (1)
I- WV
15-5-37326 (2)
15-5-37326 (3)
15-5-37326 (4)
15-5-37326 (5)
15-5-37326 (6)
15-5-37326 (7)
15-5-37326 (11) 15-5-37326 (12)
15-5-37326 (8)
15-5-37326 (9)
15-5-37326 (10)