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OPHTE# O'N-5•xaC65 Harnett County Department of Public Health 2 0 7 8 6 PERMIT #a~p Operation Permit New Installation X Septic Tank ❑ Repair; Nitrification Line ❑ Expansion PROPERTY LKATION: Ma,2re5, 44 Name: (owner) Cu M amt t4o "o cy-tr--5 SUBDIVISION Ns-i Ee ocw LOT # L~•~. System Installer. 7Tvc;~ Q>g.gw N Registration # Basement with plumbing: ❑ Garage 1K Number of Bedrooms Type of Water Supply: ❑ Community Public ❑ Well Distance from well 1©(3 feet System Type: -2I. a 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. ZS% ' tZLUr G910 .v 1 RC2,~ rJ~~x~15 I$a/ R ` bo V C ~,.J'Y ra Gq` E. 02~J ~ rcnrm wnumvnx I. Performance: System shall perform in accordance with Rule .1961. 11. Monitoring: As required by Rule .1961. III. Maintenance: As required by Rule .1961. Other. Subsurface system operator required? Yes ❑ NOX If yes, see attached sheet for additional operation conditions, maintenance and reporting. IV. Operation: V. Other. Following are the specifications for the sewage disposal system on the above captio ed property. Type of system: ❑ Conventional Other G1At~,tbFxL ~Qv.t t~'c~ si PNtivSd,5 Septic Tank: 1000 gallons Pump Tank: gallons Subsurface No. of exact length width of depth of Drainage Field ditches of each ditch 5C) feet ditches -3 bot ditchm N French Drain Required: Lt feet Authorized State Agent QS Date 9 1 4~1 7 'AN 7 . A ® j y 3ry y; ~ru 'a _.x ~t ,11 m r k I1 14 1 wil < G'IC { ' t ♦ .F~' , , - S3J3S `~3.~ i .b IL