OPHTE# /T-- V- -3-1277 Harnett County Department of Public Health
24053
PERMIT # Z&n 0 eratlon Pe mit
21 New Installation Septic Tank L1/ Nitrification Line ❑ Repair ❑ Expansior
PROPERTY LOCATION: !♦ c,Ynd N
Name: (owner) J • C. SUBDIVISION 5a,; P,, LOT # A_
System Installer: & Registration #
Basement with plumbing: ❑ Garage lvf Number of Bedrooms
Type of Water Supply: ❑ Community d Public ❑ Well Distance from well feet
System Type: +-ice 1; LAIp, 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
Treatment andyaisjosal, and all conditions of the Improvement Permit
r IV
PERMIT CONDITIONS: �1 Rj/9
1. Performance: System shall perform in accordance with Rule .1961. TD&
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 ❑
Following are the specifications for the sewa,disposal system on the above captioned property.
Type of system: ❑Conventional C3 Other Ls;e A051J yr yTs, Septic Tank 17-9'd' gallons Pump Tank
Subsurface No. of LL exact length width of depth of
Drainage Field ditches J of each ditch foD feet ditches 3 feet ditches ZG—D
19
French Drain Required: Linear feet
Authorized State A¢ent �c , -,I— yY10'11-� Date C4— Z— — / y
PWR Line
gallons
inches
15-5-37277(1)
15-5-37277 (2)
15-5-37277 (3)
15-5-37277 (4)
15-5-37277 (5)
15-5-37277 (6)
15-5-37277 (7)
15-5-37277 (8)
15-5-37277 (11) 15-5-37277 (12) 15-5-37277 (13)
15-5-37277 (9)
15-5-37277 (10)