OPHTE# /y 5 =J7- Harnett County Department of Public Health 24507
PERMIT # �91. Operation Permit
❑ New Installation ❑ Septic Tank ❑ Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION: 530 AeLll- --,,A
Name: (owner) �l n� ( /,� �P,(_ SUBDIVISION LOT # 3
System Installer: ye/ zg6--K A,6S Regi'stra'on #
Basement with plumbing: ❑ Garage ❑ 10mber of Bedrooms 2—
Type
Type of Water Supply: ❑ Community Eir Public ❑ Well Distance from feet
System Type: 4536 3 T 6L Types and VI Systems expire in S years.
(In accordance with Table V a) Owner st con act Health epartment 6 months prior to expiration for permit renewal.
IS
has been installed in compliance with applicable North Carolina General fta�s. Rules
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and all conditions of the Improvement Permit and construction Authorization.
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 ❑ Alorm ❑ H2OLine ❑ PWR Line
Following are the specifications for the sewage disposal ss tem on the above captioned property.
Type of system: ❑ Conventional ❑ Other ZSP-o' 1iT Septic Tank: 1000 gallons Pump Tank: gallons
Subsurface No. of exact length width of ? depth of
Drainage Field ditches _� of each ditch 7L feet ditches 3 feet ditches inches
French Drain Required: Linear feet
Authorized State Age Date 9—/7-1-7
14-5-34951 (1)
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14.5.34951 (11) 14-5-34951 (12)
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