OPHTE# //°J Z -(ZJ- Harnett County Department of Public Health
PERMIT # ),e3 )-'l Neration Permit 2 2 0 0 8
New Installation Septic Tank F~' Nitrification Line ❑ Repair ❑ Expansion
/J PROPERTY LOCATION:°<- f1 c,,s,r.
Name: (owner) ClVAI.Af SUBDIVISION LOT #
System Installer: G-rtrz• 4~ll, ~ ,1 c• Registration #
Basement with plumbing: ❑ Garage 1^ Number of Bedrooms 3
Type of Water Supply: ❑ Community ❑ Public Well Distance from well 913 feet
System Type: L 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
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PERMIT rnNnlTl0V fZ .
1. Performance: System shall perform in accordance with Rule .1961.
II. Monitoring: As required by Rule .1961.
111. 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 ❑
Following are the spp cations for the sewage disposal system on the above captioned property.
Type of system: Itl1 Conventional ❑ Other
Subsurface No. of exact length
Drainage Field ditches of each ditch feet
H2OLine ❑
PWR Line
Septic Tank: C~G6 gallons Pump Tank: gallons
width of depth of
ditches feet ditches inches
French Drain Required: Linear feet
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Authorized State Age
Alarm ❑
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