OPHTE# I3 5-31 150 Harnett County Department of Public Health 24056
PERMIT # 4-736:9 � New w erati� On Pew /
Installation ff Septic Tank /Nitrification Line ❑ Repair ❑Expansion
PROPERTY LOCATION:ssrt7iZ
Name: (owner) SUBDIVISION LOT # -tSA
System Installer: a Registration #
Basement with plumbing: ❑ Garage ❑ Num er of Bedrooms '4
Type of Water Supply: ❑ Community d Public ❑ Well Distance from well feet
System Type: Z s V and VI Systems expire in S years.
(In accordance with Table V a) Owner must contact alth Department 6 months prior to expiration for permit renewal.
This system has been installed in compliance with applicable North Carolina General Statutes, NO for Sewage Treatment and Disposal, and all conditions of the Improvement Permit and Lonstrumon minimization.
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PERMIT CONDITIONS
I. Performance: System shall perform in accordance with Rule .1961.
II. 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:
ElConventional 7Other IAM /UbI
Septic Tank: ! Z °d gallons
Pump Tank: gallons
Subsurface
Drainage Field
No. of exact length
ditches q_ of each ditch I OO feet
width of
ditches— feet
depth of r,
ditches ZZ'>f $ inches
French Drain Required: Linear feet
Authorized State AgeQf c:f a/ iy. Ca. B`� Date
13-5-31150 (1)
13-5-31150 (2)
13-5-31150 (3)
13-5-31150 (4)
13-5-31150 (5)
13-5-31150 (6)
13-5-31150 (7)
13-5-31150 (6)
13-5-31150 (9)
13-5-31150 (11) 13-5-31150 (12) 13-5-31150 (13)
13-5-31150 (14)
13-5-31150 (10)