OPHTE# F1_5 --Z' 76 Harnett County Department of Public Health
PERMIT # Wit" Operation Prmit 21 8 2 5
2T New Installation 2" Septic Tank 12"'Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION: C~ ~d I
Name: (owner) A Lo-ve~ Ct me ~ ~ SUBDIVISION LOT #
System Installer: ~C-r-V, PI Registration #
Basement with plumbing: ❑ Garage ❑ Number of~Beclrooms
Type of Water Supply: ❑ Community ❑ Public k/ Well Distance from well feet
System Type: aE Cam- 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 General Statutes, Rules for Sewage Treatment and Disposal, and all conditions of the Improvement Permit and Construction Authorization
U
c7
® t
1~~ 1
0
rt
t
lr c,> f f 4
PERMIT CONDITIONS:
1. 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 ❑ H20Line ❑ PWR Line
Following are the specifications for the sewa disposal system on th above captioned property.
Type of system: ❑ Conventional Other Ir(_ Septic Tank: 000 gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches of each ditch 9 C feet ditches feet ditches - inches
French Drain Required: Linear feet
Authorized State Agery w~1%' Date V~_
e
I
S
i.
z
^
"
a
d 2
a5r 3i
u5~
w
N
,f
!
a
q
r
2E T
n
l~
+
S
.
.x
r
'
'
'
f
.
a
1
r
I
~
-
f
N
f
C _ Z L
D
t
n
t
;lc
N
4D CD
9
67
C Y J y
N [1 {
a
9
~
o F
D
fJ N y
f
® ~
n
p
3
ID
,r
j IL
~
-t
?1
I
I
as t
i