OP R3e Harnett County Department of Public Health 24255
PERMIT # o8? Z / 0 eration Per •t /
d New Installation Se tic Tank rO Nitrification Line ❑ Repair
PROPERTY LO(ATION./�+t
Name: (owner) r SUBDIVISION LOT #
System Installer: Registration #
Basement with plumbing: ❑ GaraV ❑ umber of Bedrooms
Type of Water Sup : ❑ Community I4ublic q�� Well Distance from well feet
System Type: AY + 2LV.9�tel 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.
vr.
mb system nos been installed in compliance with applimble North Carolina General sumtes. Ruler for Sewage Treatment and Disposal, and all conditions al the Improvement Permit and Conmucion Authorisation.
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PERMIT CONDITIONS
I. Performance:
11. 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 ❑ No ❑
If yes, see attached sheet for additional operation conditions, maintenance and reporting.
❑ D -Box ❑ Pump ❑ Alarm ❑ H2O1-ine ❑ PWR Line
Following are the specifications for the sew disposal system on the Is captioned property.
Type of system: ❑ Conventional Ed Other ,>!� Septic Tank: / %zS J gallons Pump Tank: gallons
Subsurface No. of , I exact lengt width of depth of
Drainage Field ditches feet ditches 5 feet ditches�-)),K6 inches
French Drain Required: Linear feet
Authorized Sta G Date / — (o — / 7
15-5-36363r(1)- Copy 15-5-36363r(1) 15-5-36363r(2)- Copy 15-5-36363r(2) 15-5-36363r(3)- Copy
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15-5-36363r(3) 15-5-36363r(4)- Copy 15-5-36363r(4) 15-5-36363r(5)- Copy 15-5-36363r(5)
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15-5-36363r(6)- Copy 15-5-36363r(6) 15-5-36363r(7)- Copy 15-5-36363r(7) 15-5-36363r(8)- Copy
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15-5-36363r(8) 15-5-36363r(9)- Copy 15-5-36363r(9) 15-5-36363r(10)- Copy 15-5-36363r(10)
71 77�
Z 1
15-5-36363r(11)- Copy 15-5-36363r(11) 15-5-36363r(12)- Copy 15-5-36363r(12) 15-5-36363x(13)
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15-5-36363r(14) 15-5-36363r(15) 15-5-36363r(16) 15-5-36363r(17) ` 15-5-36363r(18)
46
15-5-36363x(19) 15-5-36363r(20) 15-5-36363r(21) 15-5-36363r(22) 15-5.36363x(23)