OPHTE# Ls -s —37�SY Harnett County Department of Public Health 24022
PERMIT # Z86-71 0 eration Permit ��
❑ New Installation C�Septic Tank L�' Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION: 0�t-/ 5774; eA—; /U�
Name: (owner) ML/n SUBDIVISION LOT # 13
System Installer: v L6 Registration #
Basement with plumbing: ❑ Garalle ❑ �tlumber of Bedrooms 3
Type of Water Supply: El Community � Public ❑ Well Distance from well feet
System Type: 1 L.. 2 T ua_ Types V and A Systems expire in S years.
(in accordance with Table V a) 0 ntact Health Department 6 months prior to expiration for permit renewal.
This sestem has been installed in mmoliana with aoDliable Northstarda General Statutes, Rules for Sewage Treatment and Disposal, and all anditiona of the Improvement Permit and Construction Authorization.
I. Performance:
11. Monitoring:
III. Maintenance:
IV. Operation:
V. Other.
�V sr.Ark
74 w'7 y'
-pQ /t 4..0
System shall perform in accordance with Rule .1961. I
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 ❑ H10Line ❑ PWR Line
Following are the specifications for the sewage disposal system on the above captioned property.
Type of system: 11Conventional f3 Other ZSR/ca C9Septic Tank: /oep ) gallons Pump Tank: /^ d gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches `4 of each ditch LO feet ditches 3 feet ditchesy -/Cj inches
French Drain Required: Linear feet
y - y — / (
Authorized State Ag��i.. / �(Ai✓fi ��� Date p
15-5-37654 (1)
15-5-37654 (2)
15-5-37654 (3)
15-5-37654 (4)
15-5-37654 (5)
15-5-37654 (6)
15-5-37654 (8)
15-5-37654 (9)
15-5-37654 (10)
15-5-37654(11) 15-5-37654(12) 15-5-37654(13)
15.5-37654 (14)
15-5-37654 (15)