SKM_454e17062812340HTE# Hai_._tt County Department of Publil. .iealth 24485
PERMIT # ZtN 84 Operation Per It
Li New Installation Y Septic Tank L2" Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION: /t o& 0/ b
Name: (owner) A/J:;t) C�,ec— SUBDIVISION LOT #
System Installer: SY-4'7� 13, b,4, Registration #
Basement with plumbing: ❑ Garage Number of Bedrooms
J
Type of Water Supply: ❑ Community LTJ Public Cg/Well Distance from well /OO ' feet
System Type: _��tllp lZdl-- 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 compliance with applicable North Carolina General Statutes, Rules for Sewage Treatment and Disposal, and all conditions of the Improvement Permit and construction Authorization
rcnml s.unuumm:
I. Performance:
II. 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 ❑
following are the sped Ions for the sewage disposal system on the above captioned property.
Type of system: Conventional ❑ Other
Subsurface No. of exact length
Drainage field ditches Z— of each ditch 2100 feet
A
H2OLine ❑
PWR Line
Septic Tank 7,&b gallons gallons Pump Tank: gallons
width of depth of
ditches 3 feet ditches Z?11/8 inches
French Drain Required: Linear feet
Authorized State A : Date Cv l 4 — 1'7
16-5-39482 (1) 16-5-39482 (2) 18-5-39482 (3) 16-5-39482 (4) 16-5-39482 (5)
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16-5-39482(6) 16-5-39482(7) 16-5-39482(8) 16-5-39482(9) 16-5-39482(10)
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16-5-39482(11) 16-5-39482(12) 16-539482(13) 16-5-39482(14) 16-5-39482(15)
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-39482 (20)
16-5-39482(21) 16-539482(22) 16-5-39482(23) 16-5-39482(24) 16-5-39482(25)
16-5-39482(26)
16-5-39482 (1) 16-5-39482 (2) 16-5-39482 (3) 16-5-39482 (4) 16-5-39482 (5)
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16-5-39482(6) 16-5-39482(7) 16-5-39482(8) 16-5-39482 (9) 16-5-39482(10)
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16-5-39482(11) 16-5-39482(12) 16-5-39482(13) 16-5-39482(14) 16-5-39482(15)
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16-5-39482(16) 16-5-39482(17) 16-5-39482(18) 16-5-39482(19) 16-5-39482 (20)
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16-5-39482(21) 16-5-39482(22) 16-5-39482(23) 16�-5-39482(-24) 16-5-39482(25)
16-5-39482 (26) 16-5-39482 (27) 16-5-39482(28) 16-5-39482(29) 16-5-39482(30)
16-5-39482(31) 16-5-39482(32) 16-5-39482(33) 16-5-39482(34) 16-5-39482(35)