OPHTE# 15-5-3-753 Harnett County Department of Public Health 23990
PERMIT # a—�h6aLl Operation Permit
New Installation 49� Septic Tank Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION: CoyNT2y5 0L O2
Name: (owner) Tvlc�E iiOME,S LLC SUBDIVISION o 7"7 LOT # 52.
System Installer: Registration #
Basement with plumbing: ❑ Garage LX Number of Bedrooms_
Type of Water Supply: ❑ Community 79 Public ❑ Well Distance from well feet
System Type: Types V and VI Systems expire in 5 years.
(In accordance with Table V a) Owner must contact Health 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
PtKMI I IUNVI I IUNS:
I. Performance:
If. 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 ❑ Noo
I If yes, see attached sheet additional operas n
maintenance and reporting.
❑ D -Box ❑ Pump ❑ Alarm ❑ H2OLine ❑ PWR Line
Following are the specifications for the sewage disposal system on the vel captition roperty.
Type of system:
El 11 Other Gvj S(aboWt� Septic Tank: P4,S-6 gallons Pump Tank: i1Od 0 gallons
Subsurface No. of exact length width of depth of
Drainage field ditches )i of each ditch aSD feet ditches 3 feet ditches Y%-30 inches
French Drain Require
Authorized State Agent rl Date �R
P
L
N Ouse
O
2
IV
cots 52451A6 p2
PtKMI I IUNVI I IUNS:
I. Performance:
If. 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 ❑ Noo
I If yes, see attached sheet additional operas n
maintenance and reporting.
❑ D -Box ❑ Pump ❑ Alarm ❑ H2OLine ❑ PWR Line
Following are the specifications for the sewage disposal system on the vel captition roperty.
Type of system:
El 11 Other Gvj S(aboWt� Septic Tank: P4,S-6 gallons Pump Tank: i1Od 0 gallons
Subsurface No. of exact length width of depth of
Drainage field ditches )i of each ditch aSD feet ditches 3 feet ditches Y%-30 inches
French Drain Require
Authorized State Agent rl Date �R