OPNTE# %IS- 31730 Harnett County Department of Public Health 24005
PERMIT # Operation Permit
New Installation 'X Septic Tank X Nitrification Line 1:1Repair 11Expansion
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PROPERTY LOCATION: *AILt_ 1—vc.w3 Rn
Name: (owner) �lLPaTaC— SUBDIVISION S -"&w w NTT LOT #�
System Installer: Honopit4 SF-es.rr Registration #
Basement with plumbing: ❑ Garage Number of Bedrooms LI
Type of Water Supply: ❑ Community Public ❑ Well Distance from well feet
System Type: c, Types V and VI Systems expire in S 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 comphanoe wuh apphzable Noah Carolina General Statutes, Rules for Sewage Treatment and Disposal, and all conditions of the Improvement Permit and Construction Authorization
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PERMIT CONDITIONS
1. Performance: System shall perform in accordance with Rule .1961.
11. Monitoring: As required by Rule .1961.
III. Maintenance: As required by Rule .1961. Other:
Subsurface system operator required? Yes ❑ No
If yes, see attached sheet for additional operation conditions, maintenance and reporting.
IV. Operation:
V. Other.
❑ D -Box ❑ Pump ❑ Alarm ❑ H2OLine ❑ PWR Line
Following are the specifications for the sewage disposal system on the above captioned property.
Type of system: ❑ Conventional Other E'Z Viry Septic Tank: 1 DO 0 gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of
Drainage F ditches l of each ditch -a 40 feet ditches 3 feet ditches 2C"46 inches
French Drain Required_ \ Linear feet
Authorized State Agent Date 4/ -1015
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IS -5-±3330
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