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OPHTE# c)9 -s ~~ss3 Harnett County Department of Public Health 2 0 8 3 0 PERMIT # Operation Permit New Installation Septic Tank ❑ Repair , Nitrification Line ❑ Expansion PROPERTY LOCATION: -1'~E~z Qn Name: (owner) 05-!5 ~~O ~v \ LOeg.~, SUBDIVISION ALN V~ ~a~vL LOT # 1 System Installer: L--or+ H "E 01A.. so t`1 Registration # Basement with plumbing: ❑ Garage 'M Number of Bedrooms Type of Water Supply: ❑ Community Public ❑ Well Distance from well 1C)6 feet System Type: 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. ma system nas peen mstanea in compuance vam apphcaowe north tarolma beneral Statutes, Rules for Sewage Treatment and Disposal, and all conditions of the t GoNvb.~'stoNgL Q.EP a s 61.,. 1 3~~ t Ada. I S~ Ks-b I-, ~ Q ~N TM .S sspE r- I ►Tt: Permit and Construction Authorization. 45-4, rLnrui wnvnivna: 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 ❑ N If yes, see attached sheet for additional operation conditions, maintenance and reporting. IV. Operation: V. Other. Ndus>r 14 Cis m Lam; S oc `T4c., teat^'n&i~ Caa- ,.-<.Eo 35 Following are the specifications for the sewage disposal system on the above captioned property. Type of system: X Conventional ❑ Other Septic Tank: 100 a gallons Pump Tank: gallons Subsurface No. of exact length width of <-->depth of Drainage Field ditches 2 of each ditch l © b feet ditches _ ;t4z30 feet ditches 3 inches French Drain Required: nea et r Authorized State Agent Date o ~TK`KVtl ~ • .Ya (3 -3 # ~ 1. ~V ~ " d r E ~z tar ~ Y•. i. ~:r E TRY ,jy~~i{'vr i ` • s ~e T Y t ~ ~ 3 l